bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Malassezia Colonization of ‘Maskne’ Patients with Seborrheic Dermatitis Cases and Healthy Individuals
Authors: Atsü Ayse N. , Caf Nazlı , Türkoğlu Zafer , Özkoca Defne , Yıldırım Ozan , Ergin Çağrı
Published: May 2024

Background:

With the Covid-19 pandemic, the use of masks has increased the frequency of 'maskne' cases. Local physiological changes due to the use of mask have caused changes in the presence of yeasts in the environment, such as acne and seborrheic dermatitis.

Objectives:

The aim is to compare the differences of Malassezia species in the maskne region.

Materials and Method:

A total of 408 subjects wearing masks at least 4 h a day for 6 weeks or longer, compromised of 212 acne patients, 72 seborrheic dermatitis sufferers, and 124 healthy volunteers were included in this study. Swab samples were taken for Malassezia cultures from nasolabial area and their control retro auricular region. The Statistical Package for Social Sciences (SPSS) version 22 was used for the statistical analysis.

Results:

Malassezia species was most frequently found in the nasolabial region of the seborrheic dermatitis group. Malassezia species were more commonly isolated from the nasolabial region of acne and seborrheic dermatitis patients, compared to the retroauricular region of each patient, than the healthy subjects. The rate of M. globosa isolated from the nasolabial region was high in all groups, the isolation rate of M. restricta was low (P < 0.05).

Conclusion:

As Malassezia species are more commonly isolated from the nasolabial region of acne and seborrheic dermatitis patients, the increasing numbers of Malassezia species will trigger inflammation with an antibody reaction against these yeasts. Treatment of resistant acne and seborrheic dermatitis will be facilitated with the knowledge of this inflammation.
Is There a Pathogenetic Relationship Between Alopecia Areata and Familial Mediterranean Fever?
Authors: Atış Güldehan , Eroğlu Simge Süel , Güldiken Gaye
Published: May 2024

Alopecia areata (AA) is type of autoimmune, T-cell-mediated disease with abnormal expression of MHC Class I, a common reason for non-scarring hair loss. Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease characterized by periodic fever and serositis. Various diseases and conditions that may be related to FMF have been reported. It has been known that patients with FMF are vulnerable to MHC Class I-related diseases. The co-existence of the two MHC Class I group-associated entities, FMF and AA, has not been reported in the literature. Here, we present three cases with AA and FMF and discuss the possible common pathway in their pathogenesis.
Melanoacanthoma, Plasma Cell Cheilitis and Langerhans Cell Hyperplasia on the Lower Lip
Authors: Silva Evânio V. , Silveira Heitor A. , Nogueira Gustavo M. , Campos Ana C. , F. da Silva Anderson T. , León Jorge E.
Published: May 2024

Oral melanoacanthoma is an uncommon reactive lesion, characterized by basal and prickle cell keratinocyte proliferation surrounded by pigment-laden dendritic melanocytes. Plasma cell cheilitis (PCC) is an inflammatory disorder of unknown aetiology, microscopically presenting a dense plasma cell infiltrate. Most PCC cases affect the lower lip. Langerhans cell hyperplasia (LCHyp), a non-neoplastic counterpart of the LC proliferations, has been reported in association with chronic inflammatory skin diseases. Here, we present an unusual association of melanoacanthoma, PCC and LCHyp on the lower lip in a 59-old-year male, expanding the clinicopathological spectrum of these uncommon lesions. The dendritic melanocytes were highlighted by Fontana–Masson stain and HMB-45, whereas S100, CD1a and CD207 evidenced numerous LCs. MUM1/IRF4, EMA, and CD138 highlighted sheets of polyclonal plasma cells, with an IgG4+/IgG+ ratio of 24%. FTA-ABS test for syphilis was negative.
Efficacy and Safety of Carboxytherapy versus Combined Microneedling with Topical Glutathione in the Treatment of Patients with Periorbital Hyperpigmentation
Authors: Assaf Hanan A. , Ahmed Dina , Abdelhamed Amr
Published: May 2024

Background:

Periorbital hyperpigmentation (POH) is a common skin condition that presents as infraorbital darkening. POH has a multifactorial etiology. Studies evaluating POH treatment are several with varying satisfaction results.

Objectives:

To compare carboxytherapy and microneedling (MN) combined with topical glutathione for POH treatment.

Materials and Methods:

A split-face pilot clinical trial was conducted on 31 female patients with POH. Carboxytherapy injection was done at the right periorbital area, and MN with topical glutathione (Left periorbital area), for 6 biweekly sessions. Visual analogue scale (VAS), dermoscopic evaluation, patient satisfaction, and patient dermatology life quality index questionnaire (DLQI), safety evaluation were done with 3 months follow up. The trial registry number is NCT04389788.

Results:

Carboxytherapy showed a higher significant improvement as regards VAS evaluation compared to MN with glutathione during the active treatment phase (P = 0.001) and during the follow-up phase (P = 0.006). Also, the dermoscopic evaluation showed a statistically significant improvement in the Carboxytherapy group. DLQI showed a statistically significant improvement (P <.001). As regards patient satisfaction, carboxytherapy showed in comparison to MN with glutathione (80.6% vs 25.8% in moderate satisfaction) and (3.2% vs 0% in marked satisfaction respectively) (P = .05). As regards the patients' safety, there was no significant difference between both eyes (P = .23).

Conclusions:

Carboxytherapy showed higher efficacy than MN with glutathione in POH patients. Carboxytherapy improved clinical, dermoscopic, patient satisfaction, and patient DLQI; with a good safety profile.
Sex Differences in Alopecia Areata Treated with Steroid Pulse Therapy
Authors: Kokubu Hiraku , Kato Takeshi , Fujimoto Sino , Tanaka Toshihiro , Fujimoto Noriki
Published: May 2024

Context:

Few reports focused on the sex differences in alopecia areata (AA) treated with steroid pulse therapy.

Aims:

This study aimed to investigate the association between the clinical outcomes and distinction of gender in AA patients treated with steroid pulse therapy.

Settings and Design:

This study retrospectively investigated 32 cases (15 males and 17 females) treated with steroid pulse therapy at the Department of Dermatology at the Shiga University of Medical Science between September 2010 and March 2017.

Methods and Material:

The administration of corticosteroid was 500 mg methylprednisolone intravenous infusion for 3 consecutive days. Patients were followed up approximately once a month until March 2017.

Statistical Analysis Used:

The respective data were analyzed by examining and comparing males and females. Statistical analysis was performed using t-test and χ2 test.

Results:

There were no significant differences in periods from the onset of AA to the administration of steroid pulse therapy (P = 0.2), the degree of severity (P = 0.37) and improved rate (P = 0.0772) between males and females. In contrast, the remission rate was 20% (3 of 15 males) and 71% (12 of 17 females), which was statistically significant (P = 0.0042). Previous reports have also shown a significant difference in the remission rate between males and females (males: 32 of 114; females: 51 of 117; P = 0.014).

Conclusions:

Despite the limitations of a small sample size including the previous reports (n = 261), female patients with AA would have better outcomes than male patients after steroid pulse therapy.
Clinical Dermatology and COVID-19 Pandemic
Authors: Mintoff Dillon , Chatterjee Manas , Podder Indrashis , Shipman Alexa , Das Anupam
Published: May 2024

The coronavirus disease of 2019 (COVID-19) pandemic has radical repercussions on every aspect of medical science, including dermatology. The magnitude of the impact on clinical dermatology cannot be overemphasized. Dermatologists have been forced to modify and reconsider the way they consult patients. Teledermatology has come up in a big way, with most of the clinicians resorting to technology and software-based consultations. Management of different dermatological conditions like papulosquamous disorders, vesiculobullous disorders, malignancies, etc., needs to be modified as per the different recommendations proposed by expert panels. This review is an attempt to highlight the impact of this destructive pandemic on various aspects of clinical dermatology.
Dermatological Manifestations Associated with COVID-19 Infection
Authors: Panda Maitreyee , Dash Siddhartha , Behera Biswanath , Sil Abheek
Published: May 2024

The severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) causing the 2019 coronavirus disease (COVID-19) has infected millions in recent years and is a major public health concern. Various cutaneous manifestations of the COVID-19 disease have been identified. Skin is a mirror to internal disease and can be the presenting sign of COVID-19 disease. Several cutaneous manifestations can indicate severe COVID-19 disease. In the present scenario, physicians should know the various cutaneous manifestations of COVID-19 disease for early diagnosis and proper management of the disease.
Virology and Etiopathogenesis of COVID-19 with Special Reference to Cutaneous Implications
Authors: Sarkar Rashmi , Bhargava Shashank , Mendiratta Vibhu
Published: May 2024

Severe Acute Respiratory Virus Corona Virus 2 (SARS-CoV-2) has got its name Corona from Latin meaning “crown.” It has crown-like spikes present on the surface, which encloses the RNA, genetic material of this deadly virus. The virus attacks pneumocytes after binding with the angiotensin-converting enzyme 2 (ACE2) of the cell surface, which ultimately leads to chemotaxis followed by leukocyte infiltration, increased permeability of blood vessels and alveolar walls, and decreased surfactant in the lung leading to various symptoms. Skin provides a window to the internal changes of the body and also to mechanisms that are not readily visible. Commonly observed skin manifestations include vesicular lesions, maculopapular exanthema, urticarial eruptions, livedo or necrosis, and other forms of vasculitis, chilblain-like lesions. The skin lesions are attributed to either the virus directly affecting the skin or interferon dysregulation due to viral RNA or vascular involvement associated with alteration in coagulation or drug-induced skin manifestations. Observation of skin involvement and the vasculature due to SARS-CoV-2 illustrates the need for a precise stratification and differential diagnostic valuation so that the mechanisms of this novel virus are clearer for better management of the condition in the future. Vascular skin lesions are not seen in all the patients of COVID, but certain lesions should definitely alarm us to evaluate for coagulation abnormalities, complement levels, and skin biopsy, especially in critically ill patients. This review attempts to outline the pathogen briefly and the pathomechanism behind the development of various cutaneous manifestations.
Study of Clinical and Dermoscopic Features in Nails of Papulosquamous Disorders and their Correlation with Disease Severity
Authors: Subudhi Anita , Jena Swapna , Mohanty Prasenjeet , Panda Dinesh R.
Published: May 2024

Background:

As face is the index of the mind, so is the nail the index to health, as the nail is capable of mounting only a limited number of reaction patterns to the large number of disorders affecting it. Dermoscopy is thus a valuable aid not only in enhancing visible nail features but also in revealing cryptic features of diagnostic value.

Aims:

To study the clinical and dermoscopic features in nails of papulosquamous disorders and correlate it with disease severity.

Methods and Material:

This was a cross-sectional study with convenient sampling. After obtaining ethical clearance, according to inclusion and exclusion criteria, papulosquamous disorders were enrolled in the study. Finger nails and toe nails were numbered 1–10. Detailed clinical examination was done. Wet and dry dermoscopic examination was made in both polarised and non-polarised mode using ultrasound (USG) gel. Psoriasis area and severity index (PASI) and body surface area (BSA) were compared with nail changes. Statistical analysis of data was performed using the Statistical Package for the Social Sciences (SPSS) version 26.

Results:

Out of 203 patients, 117 were male. Psoriasis was the most common disease (55.6%). A total of 65.51% of patients had nail changes. Pitting was the most common finding in psoriasis, both dermoscopically and clinically. Splinter haemorrhage, oil drop, dilated capillaries, and pseudofibre sign were detected better on dermoscopy (P < 0.05). Positive correlation was found between PASI and nail psoriasis severity index (NAPSI). A strong correlation was also found between clinical (cNAPSI) and dermoscopic (dNAPSI). Thinning was the most common in lichen planus. No relation between BSA and nail changes was observed.

Conclusions:

Dermoscopy is thus a valuable aid not only in enhancing visible nail features but also in revealing cryptic features of diagnostic value and reducing the requirement for invasive procedures like nail biopsies, early diagnosis, directing management.
Correlation of Serum 25-Hydroxy Vitamin D and Interleukin-17 Levels with Disease Severity in Acne Vulgaris
Authors: Singh Ajeet , Khurana Ananta , Sardana Kabir , Dixit Niharika , Chitkara Anubhuti
Published: May 2024

Background:

The association of Vitamin D (vit.D) and Interleukin 17 (IL-17) with acne vulgaris is uncertain in spite of induction of IL-17 by Propionibacterium acnes (P. acnes) and the role of vit.D in various inflammatory skin disorders including acne. The objectives of present study were to evaluate the levels of serum 25-hydroxyvitamin D3 [25(OH)D] and IL-17 in acne patients and age- and sex-matched controls and to compare them with the severity of acne as measured by Global Acne Grading System (GAGS).

Methods:

The study included 50 patients of acne and 30 healthy controls. Serum 25(OH) D and IL-17 levels were measured using chemiluminescence immunoassay (CLIA) and enzyme-linked immunosorbent assay (ELISA), respectively.

Results:

Vitamin D deficiency was detected in 28% of patients with acne but only in 6.7% of the healthy controls (P value 0.022). The levels of 25(OH)D were inversely associated with the severity of acne (P < 0.001). The mean serum IL-17 levels were significantly raised (P < 0.001) in acne patients (8.215 ± 5.33 pg/mL) as compared to controls (2.486 ± 2.12 pg/mL). A significant rise in levels of IL-17 was observed with the severity of acne (P < 0.001). Further, a highly significant negative correlation (Correlation Coefficient: -0.668) was noted between serum IL-17 and 25(OH) D levels along with disease severity in acne patients (P value < 0.001).

Conclusions:

Raised IL-17 levels in acne correlate negatively with vit.D deficiency and both are significantly more prevalent in patients with acne as compared to healthy controls.
Psoriasis in Pediatric Age Group
Authors: Dhar Sandipan , Srinivas Sahana M.
Published: May 2024

Psoriasis is a common, chronic, immune-mediated, multisystem, inflammatory disorder. It affects all age groups, including infancy. In one-third of the cases, the onset of the disease is in the first and second decades of life. Childhood psoriasis significantly affects the quality of life of the child as well as that of the entire family. Pediatric psoriasis has distinct clinical presentations and evolves with time. Like in adults, chronic plaque psoriasis has been found to be the most common type of childhood psoriasis. Psoriatic plaques in children are less pruritic, smaller and thinner with less prominent scaling. In pigmented skin, the erythema is less prominent and plaques appear violaceous or hyperpigmented. Pediatric psoriasis can be associated with arthritis, metabolic syndrome, depression and anxiety. Hence all children should be screened routinely for associated comorbidities. Management of pediatric psoriasis is challenging owing to the limitation of approved therapies. 'Proactive therapy' is a recent approach in childhood-onset psoriasis that would help to prevent the severity of flare-ups, thus improving the quality of life.
Perception and Knowledge of Hidradenitis Suppurativa in Greece
Authors: Liakou Aikaterini I. , Papadakis Marios , Tsantes Andreas G. , Tsante Konstantina A. , Kontochristopoulos Georgios , Marnelakis Ioannis , Katoulis Alexandros , Grigoriou Stamatios , Rigopoulos Dimitris
Published: May 2024

Background:

Hidradenitis suppurutiva (HS) is a chronic auto-inflammatory disease with recurrent painful deep-seated nodules.

Aims:

The aim of this study was to qualitatively assess patients’ perception for HS.

Methods:

A descriptive two-step questionnaire survey was conducted from January 2017 to December 2018. The survey was performed through self-assessed, online, standardized questionnaires. Clinico-epidemiological characteristics, medical history, comorbidities, personal perceptions and the impact of the disease on participants’ professional and everyday life were recorded.

Results:

A total number of 1301 Greek people completed the questionnaire. Of them, 676 (52%) reported symptoms resembling HS, whereas 206 (16%) reported that have been officially diagnosed with HS. The mean age of the study group was 39.2 ± 11.3 years. More than half of the diagnosed patients (n = 110, 53.3%) reported that they developed their first symptoms between 12 and 25 years of age. Of the diagnosed patients (n = 206), the majority (n = 140, 68.0%) were females and active smokers (n = 124, 60.1%). Seventy-nine (n = 79, 38.3%) patients reported a positive family history for HS. Ninety-nine (n = 99, 48.1%) patients reported that HS has a negative effect on their social life, 95 (46.1%) on personal life, 115 (55.8%) on sexual life, 163 (79.1%) on their mental health and 128 (62.1%) on their overall quality of life.

Conclusion:

Our study showed that HS seems to be an underteated, time-consuming and cost-intensive disease.
Pseudoxanthomatous Mastocytosis in a 2-Month Female Infant
Authors: Rai Tulika , Mohan Atul , Dhameja Neeraj , Yadav Vandana
Published: May 2024

Mastocytosis is a rare disease characterized by infiltration of mast cells in various tissues like skin, bone marrow, liver, spleen, and gastrointestinal tract. Here, we present a case report of diffuse cutaneous mastocytosis (pseudoxanthomatous type) in a neonate which is a rare presentation.
Barriers for Antiretroviral Therapy Adherence and Viral Suppression in Members of the Key Population in Mumbai, India
Authors: Acharya Shrikala , Parthasarathy M. , Palkar Amol , Keskar Padmaja , Setia Maninder Singh
Published: May 2024

Background:

Poor adherence to antiretroviral therapy (ART) is associated with poor virologic control and drug resistance in people living with HIV/AIDS. Some barriers to ART adherence are cost, lack of information, stigma, or dissatisfaction with health services.

Aims and Objectives:

To study the association between barriers for ART adherence and viral suppression, and explore the role of "missing ART dose" as a potential mediator in high-risk groups.

Materials and Methods:

Demographic, clinical, and behavioral data from 50 "virally suppressed" (viral load [VL] <1000 copies/ml) and 48 "not suppressed" (VL > 1000 copies/ml) individuals belonging to the key population in Mumbai were collected. Sociodemographic, behavioral, and other characteristics were compared, and mediation analysis was used to identify the mediator in the pathway to viral suppression.

Results:

Those who had missed their ART at least once in the past three months (37% versus 60%, P = 0.03) and stayed alone were less likely to be virally suppressed (31% versus 69%, P = 0.002). Individuals who had negative perception about ART (adjusted odds ratio [aOR]: 0.11, 95% confidence interval [CI]: 0.02, 0.47; P = 0.002), poor ART-related knowledge/behaviors (aOR: 0.14, 95% CI: 0.03, 0.60; P = 0.007), and poor pill taking practices (aOR: 0.10, 95% CI: 0.02, 0.61; P = 0.01) were significantly less likely to be virally suppressed. The mediation pathway "adherence theme > missed ART in the past three months > viral suppression" was significant in these themes.

Conclusions:

The factors associated with low viral suppression were knowledge/behaviors, perceptions about ART, and poor pill taking practices. Thus, it is important to provide correct information about ART, its effects, side effects, and potential limitations to marginalized population. Involving brothel keepers and Gurus (head of male-to-female transgendered people/Hijras clans), and technology enabled customized counseling sessions will be helpful.
Prevalence of Anxiety and Depression among People Living with Leprosy and its Relationship with Leprosy-Related Stigma
Authors: Sharma Pawan , Shakya Rabi , Singh Swarndeep , Bhandari Anup Raj , Shakya Rajesh , Amatya Amit , Joshi Chunauti , Gurung Grisha
Published: May 2024

Background:

Leprosy, a chronic infectious disease, is associated with a high risk of psychiatric disorders.

Aims and Objectives:

We aim to estimate the prevalence of anxiety and depressive symptoms among people living with leprosy at a special community residence in Nepal. We also aimed to find the correlation between anxiety and depression.

Materials and Methods:

This is a cross-sectional descriptive study conducted in a community of people with leprosy staying at a centre in Nepal using all enumerative sampling. The semi-structured schedule, hospital anxiety and depression scale and stigma assessment and reduction of impact (SARI) stigma scale were applied among 119 participants.

Results:

About 10.1% (n = 12) and 12.6% (n = 15) of participants scored above the threshold score indicative of definitive clinically significant anxiety and depression symptoms. In multivariable analysis, leprosy-related stigma and attribution of leprosy to bad deeds were significant correlates of anxiety; whereas leprosy-related stigma and duration of stay at the centre were significant correlates of depression.

Conclusion:

The prevalence of depression and anxiety symptoms among people living with leprosy is higher than that in the general population. Sigma is a significant correlation for both. It is important to screen for mental health issues while managing patients with leprosy and implement strategies aimed at leprosy-related stigma reduction.
Primary Hyperhidrosis
Authors: Abusailik Mohammad A. , Mustafa Safa M. Bani , Alzboun Habes M. , Al-issa Hussam A. , Oweis Sami W. , Alshudeifat Anas Y. , Nawaiseh Mohammed B.
Published: May 2024

Background:

Primary hyperhidrosis (PHH) is characterized by idiopathic, focal, bilateral, and symmetrical excessive and exaggerated sweating with a major impact on the quality of life (QoL). To date, there are no studies about the prevalence of PHH in Jordan and in the Arab region.

Aim:

To assess the prevalence, severity, and characteristics of PHH in the Jordanian population as well as its impact on QoL.

Material and Methods:

This study was conducted in five hospitals in Jordan and included 4,500 attendants of outpatient clinics who were evaluated for the presence of PHH. To assess the severity of hyperhidrosis (HH), we used the Hyperhidrosis Disease Severity Scale (HDSS). To evaluate the impact of HH on QoL, the Dermatology Life Quality Index (DLQI) questionnaire was answered by our patients, either digitally or on paper.

Results:

The overall prevalence of PHH in the Jordanian population was 3.2% (n = 144). The most common site was the axillae (63%), either isolated or in association with other sites. Both sexes were affected equally. The overall mean age of onset was 14.7 years. Positive family history was found in 35% of the patients. Nearly two-thirds of the patients presented with HDSS of 3 or 4. The impact on QoL was substantial with a mean DLQI of 12.8.

Conclusion:

PHH prevalence in the Jordanian population is 3.2%, which has a major impact on QoL. This raises the need for addressing this disease to reduce its burden on patient lives.
Cutaneous Adverse Drug Reactions in a Tertiary Teaching Hospital
Authors: Jadhav Anuja , Patil Sharmila , Manchanda Isheeta , Hasija Ruchita , Patil Anant
Published: May 2024

Objective:

To describe clinical patterns, identify associated drugs, and perform causality assessment of cutaneous adverse drug reactions.

Materials and Methods:

In this prospective, observational study, patients with signs of cutaneous drug reaction from the department of dermatology of a tertiary teaching hospital were included. Patients with viral exanthemas were excluded. The patterns of cutaneous drug reactions, and associated drugs were noted. Naranjo scale was used for causality assessment of adverse drug reactions.

Results:

Sixty-five patients (mean age 38.1 years) were included. Skin lesions were seen after 2 days of drug consumption in 25 (38.5%) patients. Pigmentation, fixed drug eruption, and maculo-papular rashes were seen in 13 (20%), 22 (33.8%), and 12 (18.5%) patients, respectively. Thirty-five (53.85%) patients had other associated symptoms. Fever was seen in 22 (33.8%) patients. Thirty-two (49.2%) cases had exposure to antibacterial agents. Most commonly associated drugs with reactions were nonsteroidal anti-inflammatory agents 14 (21.5%) followed by beta-lactam antibiotics 12 (18.5%), and fluroquinolones 7 (10.8%). Fifty-seven (87.7%) adverse drugs reactions had “probable” association with the drug.”

Conclusion:

Fixed drug eruption is the commonest presentation of cutaneous adverse drug reactions and antimicrobial agents are most commonly associated with it. According to the Naranjo scale, the majority of the cutaneous drug reactions have a “probable” association with the offending drugs.
Tattoos
Authors: Altunay İlknur Kıvanç , Güngör İlayda Esna , Ozkur Ezgi , Aydın Cigdem , Manav Vildan , Ozden Hatice Kaya , Ertekin Sumeyre Seda , Calikoglu Emel Erdal , Erdoğan Hilal Kaya , Taskin Banu , Ficicioglu S. , Memet Bachar , Gürok Neşe Göçer , Ermertcan Aylin Turel
Published: May 2024

Background:

Tattoos are very popular in today's world. Objectives: The aim of this study was to determine the demographics, the characteristics of tattoos, motivations for getting tattoos, tattooing practices and tattoo regret.

Materials and Method:

This multi-centre, cross-sectional study was conducted among. 302 patients attending to the dermatology outpatient clinics and having at least one tattoo. A questionnaire form including all needed data about patients, tattoo characteristics and possible reasons for obtaining tattoos was designed and applied to all participants.

Results:

Of 302 patients, 140 (46,4%) were females and 162 (53,6%) were men. The mean age was28,3 ± 8,1 years (min-max, 16–62) for all study group, 53% of participants (n = 160) had at least one tattoo involving letters or number, 80 participants (26%) stated regret for at least one of their tattoos, and 34 of them (42,5%) had their unwanted tattoo removed or camouflaged with a new tattoo. The most common reason for regret was ‘not liking the tattoo anymore’. The most common motivations for having tattoos were ‘to feel independent’, ‘to feel better about himself/herself’ and ‘to look good’. Women had higher scores than men regarding tattoo motivations of ‘to be an individual’ and ‘to have a beauty mark’.

Conclusion:

Given the rates, tattoo regret is a significant issue and as motivations differ between genders, age groups and other demographic characteristics; tattoos are not just an ink or drawing on the body, but a tool for individuals to express themselves and to construct self-identity. Tattoos have deep symbolic meanings for emotions, and they may be a clue for behavioural patterns of individuals.
Localized Linear IgA Bullous Dermatosis and a Recurrent Cicatricial Ectropion of the Eyelid
Authors: Drnovšek-Olup Brigita , Matović Katja
Published: May 2024

Cicatrizing ectropion of the eyelid is an uncommon condition, possibly resulting in significant ocular morbidity. A potential cause can be a systemic disease, including autoimmune blistering disease (ABD). We herein report a case with a sixteen-year follow-up of a patient with a chronic cicatrizing unilateral ectropion caused by linear IgA bullous dermatosis (LABD). LABD is an ABD, characterized by the accumulation of IgA anti-basement membrane autoantibodies. It has a varied presentation; however, localized or ophthalmic manifestations have been infrequently described. The case demonstrates the benefits of immunohistochemistry in obtaining the correct diagnosis, and difficulties in the medical and surgical management of a recurrent cicatricial ectropion caused by chronic systemic disease.
Assessment of Oxidative/Nitrosative Stress and Raftlin in Vitiligo
Authors: Mulayim Mehmet K , Kurutas Ergul B , Nazik Hulya , Ozturk Perihan
Published: May 2024

Background:

Vitiligo is a chronic skin disease characterized by white macules on the skin due to loss of melanocytes. Although there are many theories about the etiopathogenesis of the disease, oxidative stress is identified as an important determinant in the etiology of vitiligo. In recent years, Raftlin has been shown to play a role in many inflammatory diseases.

Aims:

The aim of this study was to compare the patients with vitiligo and the control group to determine both oxidative/nitrosative stress markers and Raftlin levels.

Materials and Methods:

This study was designed prospectively between September 2017 and April 2018. Twenty-two patients diagnosed with vitiligo and 15 healthy people as the control group were included in the study. Blood samples collected to determine oxidative/nitrosative stress, the antioxidant enzyme, and Raftlin levels were sent to the biochemistry laboratory.

Results:

In patients with vitiligo, the activities of catalase, superoxide dismutase, glutathione peroxidase, and glutathione S transferase were significantly lower than in the control group (P < 0.0001). In vitiligo patients, the levels of malondialdehyde, nitric oxide, nitrotyrosine (3-NTx), and Raftlin were significantly higher than in the control group (P < 0.0001).

Conclusions:

The results of the study support that oxidative stress and nitrosative stress may play a role in the pathogenesis of vitiligo. In addition, the Raftlin level, a new biomarker of inflammatory diseases, was found high in patients with vitiligo.
Evaluation of the Knowledge, Attitude and Practice of Patients on Immunosuppressive Drugs Towards COVID-19 Attending Dermatology Department- A Multicentric Cross-Section Study
Authors: Mohta Alpana , Mohta Achala , Nai Radhe Shyam , Arora Aakanksha , Aggrawal Aditi , Jain Suresh Kumar , Mehta Rajesh Dutt , Singh Arti
Published: May 2024

Background:

The deadly COVID-19 (Coronavirus Disease 2019) or SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) was identified for the first time in December 2019 from Wuhan, China, and by the beginning of March 2020, it was declared a pandemic by the World Health Organization (WHO). Despite so many government regulations and awareness measures, there is still a lacuna between the gravity of illness and the knowledge of the average person toward it.

Objective:

We aimed at assessing the knowledge, attitude, and behavioral practice (KAP) of patients on immunosuppressive medication attending the dermatology department toward, COVID-19.

Material and Methods:

A self-designed printed/digital questionnaire consisting of 30 questions (Hindi and English) was supplied to patients being treated with any systemic immunosuppressives (for at least 3 weeks), for any dermatological ailment. The questionnaire consisted of 12 questions assessing the knowledge, 11 for attitude, and 7 for practices of patients toward COVID-19.

Results:

The study included 237 patients with a mean age of 44.57 ± 13.72 years. The correct knowledge toward COVID-19 was present in 126 (53.16%) patients with a mean score of 7.79 ± 3.08 out of 13. The mean attitude score was 8.35 ± 2.16 (out of 11) while the mean score of practice was 5.64 ± 2.03 (out of 8). Increased hygiene levels were seen in 220 (92.83%) patients. Sixty-six (27.85%) patients admitted to stopping their prescribed immunosuppressives by themselves during COVID-19 and a significant proportion agreed to the use of alternative medicines with questionable efficacy (n = 91; 38.39%). A significant difference in KAP was found across various strata of society like gender, age, socioeconomic status, literacy, and residence (P < 0.001).

Limitations:

Our study was limited by small sample size, absence of a control group with healthy individuals, and short duration of the study.

Conclusions:

Most of the participants had poor knowledge, a positive attitude, and good practices toward COVID-19. Proper counseling of patients and the use of telemedicine could help combat the gap in KAP without compromising the healthcare facilities needed for the management of such patients.
Evaluation of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Chronic Plaque Psoriasis
Authors: Mondal Sudeshna , Guha Samudra , Saha Abanti , Ghoshal Loknath , Bandyopadhyay Debabrata
Published: May 2024

Background:

Psoriasis is a common inflammatory dermatological condition and affects 2–3% population worldwide. Psoriasis area and severity index (PASI) and body surface area (BSA) are two commonly used scales used to measure disease severity in psoriasis patients. However, these scales are plagued by weaknesses as inter-observer variation and insufficient evaluation of micro-vascular inflammation. Thus, it is necessary to have an objective and simple measure of the severity of inflammation. The ratio of neutrophils-to-lymphocytes (NLR) and platelets-to-lymphocytes (PLR) are simple and inexpensive markers of systemic inflammatory response that can be measured as part of a complete blood count and are already used in the setting of inflammatory diseases. The utility of the NLR and PLR in psoriasis however, remains relatively unexplored.

Aims and Objectives:

The present study was undertaken to assess if NLR, PLR and C-reactive protein were altered in chronic plaque psoriasis patients as compared to controls and also to determine correlation of NLR and PLR values with disease severity as measured by PASI.

Methods:

This case control study consisted of equal numbers (45 each) chronic plaque psoriasis patients and control subjects. The subjects were evaluated by way of history taking, clinical and blood examination. Thereafter, the results were tabulated and examined statistically.

Results:

Our study results indicate that psoriasis patients tended to have a higher neutrophil count, lymphocyte count, NLR and C-reactive protein in comparison the control subjects (P < 0.05).

Conclusion:

We concluded that such easily available and low cost indices of systemic inflammation are raised in psoriasis patients and are positively correlated with the severity of involvement. They can thus not only be used to monitor the effect of systemic drugs in psoriasis.
Distribution of Cutaneous Malignancies in Eastern Rajasthan
Authors: Swain Phanindra K. , Singh Suresh , Bhalgat Bhushan S. , Kumar Pravin , Lakhera Kamal K. , Patel Pinakin , Sharma Raj G.
Published: May 2024

Background:

Cutaneous malignancies are rare with respect to other malignancies. The distribution of various histologies of these malignancies is not uniform. We aimed to study the distribution of these malignancies and their epidemiological pattern in Eastern Rajasthan with the data collected from various pathology labs in Jaipur.

Methods:

In this retrospective chart review we analysed the data of 453 patients presenting with histopathologically proven cutaneous malignancies to four major pathology departments and labs in Jaipur, Rajasthan. We recorded the distribution of these histologies according to incidence, age of presentation, gender and site predilection. The data was subsequently analysed using statistical methods.

Results:

Squamous cell carcinoma (36%)was the most common histology which was closely followed by basal cell carcinoma(31%). Malignant melanoma (13%) was the third most common histology to present. Other less common histologies to present were dermatofibrosarcoma, Kaposi sarcoma, non hidgkin lymphoma etc. The age range varied from 14 to 90 years. The mean age of presentation was 54.3 years. Male had a slight preponderance (1.36 times more than females)overall. Except Bcc, which had a female preponderance. Head and neck(38.41%) was the most common site to be affected overall followed by lower limbs(31.56%).

Interpretation:

The idea of distribution of these rare malignancies in our part of the country will not only help us in proper surgical management but also in educating the public about the possible causes and the need for early intervention leading to better prognosis.
Recurrent Aphthous Stomatitis
Authors: Elias Marcus L , Fatahzadeh Mahnaz , Schwartz Robert A
Published: May 2024

Recurrent aphthous stomatitis (RAS) is a common oral disease characterized by intermittent eruptions of painful oral ulcerations. Hippocrates first described aphthous stomatitis with the Greek word aphthi meaning “to inflame.” RAS affects 10–20% of the population with the incidence being the highest among young adults. The peak age of onset is between 10 and 19 years of age. It has three main forms of presentation. The most common being minor RAS, along with the major and herpetiform types. Many local and systemic factors are associated with RAS pathogenesis. The main concern with oral aphthae in many cases is local pain, which can be severe enough to interfere with eating, speaking, and swallowing. It is important to differentiate RAS from systemic diseases with aphthae—such as Behçet's syndrome and the newly-delineated, autoinflammatory PFAPA (periodic fever with aphthous stomatitis, pharyngitis, and adenitis) syndrome—as well as from other aphthous-like ulcerations like herpes simplex virus (HSV) or Coxsackie oral lesions. The management depends upon the clinical presentation and symptomatology—focusing on analgesic, antimicrobial, and immunomodulatory drugs.
A Case Series Depicting PSMA Expression in Nonmalignant Lesions
Authors: Ghosh Suchismita , Agrawal Archi , Choudhury Sayak , Purandare Nilendu C. , Rangarajan Venkatesh
Published: May 2024

Prostate-specific membrane antigen (PSMA) is a widely accepted and used tracer in staging and biochemical recurrences of prostate cancer. PSMA is extensively expressed in normal prostatic epithelial cells and prostate cancer cells, with some amount of expression also in nonprostatic cells. False-positive PSMA uptake in nonmalignant lesions creates ambiguity in disease detection. In such cases, histopathological correlation and radiological follow-up assist in clinical decision-making. In this case series, we illustrate a few cases where PSMA uptake was incidentally found in some of the commonly occurring benign conditions.
Incidental Tc-99m MIBI Lung Uptake in Parathyroid Scintigraphy
Authors: Benameur Yassir , Zahfir Ikram , Nakro Dounia , Oueriagli Salah Nabih , Sahel Omar Ait , Doudouh Abderrahim
Published: May 2024

Diffuse Tc-99m MIBI uptake in the lungs during parathyroid scintigraphy is exceptional, and only a few cases have described this unusual aspect. The differential diagnostic of this funding is a challenge when interpreting the examination, since it can be a sign of serious pathology. We report the case of unexpected diffusely increased Tc-99m MIBI uptake in bilateral lung fields in a patient with left cardiac dysfunction.
18-F FDG PET/CT in a Case of Recurrent Pericardial Effusion Diagnosed as Cardiac Sarcoma
Authors: Jain Anurag , Mahato Abhishek , Guleria Prerna , Vishnoi Madan Gopal , Asima Bushra , Tiwari Awadhesh
Published: May 2024

Recurrent pericardial effusion poses a diagnostic challenge, especially in young patients. We present a case of a 22-year-old female who experienced recurrent pericardial effusion and cardiac tamponade. Despite initial treatment with anti-tubercular drugs and prednisolone, the patient had a relapse of symptoms, necessitating further investigation. Imaging studies revealed massive pericardial effusion with septations, suggestive of constrictive pericarditis with impending cardiac tamponade. To establish a definitive diagnosis, the patient underwent an FDG PET-CT scan after adhering to a specific dietary regimen. The scan revealed an ill-defined mediastinal mass with high metabolic activity, along with a gross pericardial effusion showing metabolic activity in the periphery and septations. Subsequent biopsy of the mediastinal mass confirmed a diagnosis of high-grade sarcoma.Primary malignant cardiac tumors are rare, and their prognosis is generally poor due to limited treatment options. While echocardiography and MRI are commonly used imaging techniques, FDG PET-CT is not routinely employed for evaluating cardiac tumors. However, in this case, FDG PET-CT played a crucial role in identifying the mediastinal mass and confirming the diagnosis.Early detection and accurate diagnosis of cardiac tumors are vital for initiating appropriate treatment strategies. Further studies are needed to explore the utility of FDG PET-CT in the evaluation of cardiac tumors, especially in cases of recurrent pericardial effusion.
Institutional Experience of Routine Radiation Surveillance of Delay and Decay Tanks Facility in a Department Having High-dose Iodine Therapy Unit
Authors: Kaur Amandeep , Sonik Yasmeen Atwal , Sonik Bhavay
Published: May 2024

Background:

Radioactive solid and liquid waste generated by patients after high-dose iodine therapy may lead to significant radiation exposure if not properly handled.

Aims and Objectives:

This study was conducted to monitor the radiation exposure along the sewerage drainage system of the high-dose iodine therapy ward and to rule out leakage if any, that might pose a potential radiation hazard to the general public (sewerage workers) and radiation health professional.

Materials and Methods:

The sewerage drainage system from isolation wards has multiple gate valves to regulate sewerage flow from the high-dose iodine therapy ward into delay and decay tanks (DDT) built, especially for the purpose. Radiation surveillance was done using a Geiger-Muller counter-based survey meter at 11 different locations on a weekly basis for 12 weeks.

Results:

A total of 26 patients underwent high-dose iodine ablation therapy during the study period in our department, with the highest recorded radiation exposure rate in the sewerage draining system in the 9th week of patient admission. This was at the common gate valve junction (location B) that directed sewerage waste from all four isolation rooms into the common pipeline leading to DDT. Minimal radiation exposure was recorded within Atomic Energy Regulatory Board -prescribed limits with no evidence of leakage.

Conclusion:

A routine radiation survey is an important component of overall radiation safety in the nuclear medicine department, including sewerage delay tank facilities, which helps keep the radiation exposure to acceptable levels by identifying timely leakage.
Fatigue and Quality of Life after 2 weeks Post discharge in Post-COVID-19 Subjects
Authors: Muragod Anil , Nerurkar Pallavi Sujit , Pastagia Nishi Tarang
Published: May 2024

Context:

Coronavirus disease (COVID-19) pandemic affected a large number of individuals globally. Fatigue follows other viral infections; many of the hospitalized persons with a moderate to severe form of COVID-19 illness report residual symptoms, contributing to activity limitations.

Aim:

To assess the fatigue and quality of life (QOL) in post-COVID-19 subjects, 2 weeks after discharge.

Settings and Design:

An observational study was conducted on COVID-19 subjects, 2 weeks after discharge from tertiary care hospitals.

Methodology:

Subjects meeting the inclusion and exclusion criteria were recruited. Three hundred and sixteen subjects were contacted by phone call, and verbal consent was taken. The outcome measures used were the Fatigue Assessment Scale and World Health Organization QOL-BREF scale.

Statistical Analysis Used:

Statistical measures such as mean and standard deviation and descriptive statistics such as percentage analysis and Pearson's correlation test were used.

Results:

The correlation between fatigue and QOL was statistically significant, with a nonlinear association (P < 0.05). Hospital stay and fatigue were directly related, which was significant. Linear association demonstrated that age was negatively related to QOL and positively associated with fatigue.

Conclusion:

COVID-19 subjects were more likely to have fatigue and low health-related QOL even after 2 weeks of discharge. There was a significant nonlinear correlation between fatigue and QOL in COVID-19 survivors.
Correlation of Lumbar Core Strength with Functional Mobility in Community-Dwelling Elderly Adults
Authors: D'Souza Danielle Malcolm , Kulkarni Vivek N.
Published: May 2024

Context:

Aging results in changes in individual cells and organs of the body which consequently result in changes in function and appearance. These changes imply a negative influence on functional performance interfering with activities of daily living. The core muscles form an important mechanical linkage providing proximal stability and distal mobility. With age, due to fat infiltration, the core muscle strength is found to decrease.

Aims:

The study aimed to find if a correlation exists between core muscle strength and functional mobility in community-dwelling elderly individuals.

Settings and Design:

The study was an analytical cross-sectional study conducted in an urban setup in Pune.

Subjects and Methods:

A total of 103 community-dwelling elderly individuals were assessed for lumbar core strength using the Supine test of Pressure biofeedback and functional mobility using the timed up and go (TUG) test as well as the functional reach test (FRT).

Statistical Analysis Used:

Spearman correlation test was used in this study.

Results:

The study showed a significant correlation between core strength and TUG test as well as with the FRT scores (r[TUG] = −0.75, r[FRT] = 0.72).

Conclusions:

Individuals with a stronger core require lesser duration to complete the TUG test, and can reach a greater distance in the FRT.
Trunk Rotation Exercises Versus Sit-to-Stand Training with Step-Foot Position on Balance and Gait in Patients with Chronic Stroke
Authors: Babel Divya K. , Kunduru Sudheera
Published: May 2024

Context:

Muscle weakness, decreased range of motion, abnormal muscle tone, incoordination, and multisensory disintegration in stroke patients can lead to balance disturbances, reduced mobility, and higher risk for falls. There is paucity in literature whether trunk rotation exercises or sit-to-stand training protocol would be more beneficial for stroke-related disability.

Aims:

The aim of this study is to determine the comparative effect of trunk rotation exercises and sit-to-stand training with step-foot position on balance and gait in patients with chronic stroke.

Settings and Design:

Experimental study was carried out at tertiary care center.

Subjects and Methods:

Thirty stroke patients were recruited and randomly included in one of the two study groups. Group A was given trunk rotation exercises and Group B received sit-to-stand training with step-foot position for 30 min, 3 times a week, for 4 weeks. Both the groups received conventional physiotherapy for another 30 min. Balance and gait were assessed before and postintervention using the Berg Balance Scale (BBS) and Dynamic Gait Index (DGI), respectively.

Statistical Analysis Used:

The Mann–Whitney U-test was applied for the comparison of group data.

Results:

When BBS and DGI were compared at pre-and postintervention time, results were statistically significant for both groups (P < 0.001). However, when between groups posttest scores were compared for BBS and DGI, results were statistically not significant (P > 0.05).

Conclusion:

Both trunk rotation exercises and sit-to-stand training with step-foot position were equally effective in improving balance and gait in chronic poststroke subjects.