bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Observational Study Comparing the Number, the Localization and the Dermoscopic Patterns of Melanocytic Nevi in Cutaneous Melanoma and Basal Cell Carcinoma Patients
Authors: Demircan Caner , Elcin Gonca 
Published: August 2024

Context:
Number of nevi is a risk factor for melanoma and basal cell carcinoma. Studies suggest that the dermoscopic pattern of nevi of melanoma patients may differ from healthy individuals. Similar data in patients with basal cell carcinoma is missing.

Aims:
The purpose of the study was to determine the number, anatomic distribution and dermoscopic pattern of nevi in melanoma and basal cell carcinoma patients.

Settings and Design:
An observational prospective study was conducted.

Materials and Methods:
Total body mole maps of 26 melanoma and 33 basal cell carcinoma patients were analysed.

Statistical Analysis Used:
Statistical analysis was done using the “IBM SPSS for Windows Version 22.0” package programme.

Results:
Number of nevi both on head and forearm were found significantly higher in the melanoma group (P = 0.015 and P = 0.031). Most frequent dermoscopic pattern was the complex pattern which was observed in 50.67% of melanoma and in 53.41% of basal cell carcinoma groups. Percentage of nevi with homogenous pattern located on the trunk and percentage of nevi with complex pattern located on the forearm was significantly higher in the melanoma group (P = 0.030 and P = 0.042).

Conclusions:
Higher number of nevi on the head and forearms; and more nevi showing homogenous pattern on the trunk and complex pattern on the forearms were the hallmarks of nevi in melanoma patients in comparison to basal cell carcinoma patients.
Update on dermatophytosis in Mashhad, Northeastern Iran, emergence of infection with Trichophyton persicum
Authors: Afsharzadeh Fatemeh , Zarrinfar Hossein , Fata Abdolmajid , Najafzadeh Mohammad Javad 
Published: August 2024

Background:
Dermatophytosis is a common global superficial mycosis caused by a group of keratinophilic moulds known as dermatophytes that invade the skin and keratinized tissues such as hair and nails of humans and animals. This study takes identification of a collection of clinical dermatophyte isolates by using partial sequencing of translation elongation factor-1α (Tef-1α) gene aiming both to update the epidemiological status of dermatophytosis in Mashhad, Northeastern Iran and to corroborate the efficacy of Tef-1α for species-level identification of dermatophytes.

Method:
The demographic data related to 87 culture-positive dermatophytes isolated from patients clinically suspected to have dermatophytosis were collected. The dermatophyte isolates were subjected to a partial polymerase chain reaction (PCR)-sequencing of Tef-1α gene by using specific pan-dermatophyte primers. The data were analysed by SeqMan software, the sequences were compared and aligned with the GenBank database and the isolates were identified.

Results:
Identification based on Tef-1α partial sequence was successful for all isolates. The identified dermatophyte isolates in decreasing order were as Trichophyton interdigitale 19 (22%), T. tonsurans 19 (22%), T. mentagrophytes 13 (15%), T. persicum 10 (11.5%), Epidermophyton floccosum 9 (10.3%), Microsporum canis 7 (8%), T. rubrum 5 (5.7%), T. violaceum 2 (2.2%), Nannizzia fulva 2 (2.2%) and N. persicolor 1 (1.1%). The isolates have been associated with clinical forms of tinea corporis (n = 38; 43.7%), tinea faciei (n = 13; 15%), tinea cruris (n = 12; 13.9%), tinea manuum (n = 7; 8%), tinea unguium (n = 7; 8%), tinea capitis (n = 7; 8%) and tinea pedis (n = 3; 3.4%).

Conclusion:
Dermatophytosis has yet remained a public health problem in Northeastern Iran, and infection with new and less frequent species, e.g., T. persicum, N. fulva and N. persicolor have emerged. The Tef-1α gene partial sequencing reconfirmed the resolution power of this locus for the determination of species boundaries in dermatophytes.
Efficacy and Safety of Erbium-YAG Laser Ablation Therapy in Superficial Dermatoses
Authors: Arora Aakanksha , Mehta Rajesh D. , Ghiya Bhikam C. , Soni Prasoon , Mohta Alpana , Khokhar Rajesh , Jangir Vishnu K. , Yadav Manoj K. , Pareek Sumiti 
Published: August 2024

Background:
Erbium-YAG laser has been the working horse in dermatology for years. Surprisingly, data on the efficacy and adverse effects of this novel resurfacing and ablative technique of erbium-YAG laser for superficial dermatoses in Indian skin is limited.

Aim and Objective:
To evaluate the efficacy and safety profile of erbium-YAG laser ablation in superficial cutaneous lesions.

Materials and Methods:
Two hundred and fifty patients of various superficial dermatoses, treatable by erbium-YAG laser, were recruited in the study. All the patients were subjected to erbium-YAG laser sessions. The number of laser sessions, fluence, frequency and other parameters were individualized as per the respective dermatosis. The clinical response was evaluated as grade 4 (100% lesion clearance), grade 3 (75–99%), grade 2 (50–75%) or grade 1 (<50%).

Results:
The overall mean age of our study group was 37.70 years. In our study, 52.38% cases of verruca plana, 36.84% cases of seborrheic keratosis, 56.4% cases of xanthelasma palpebrarum, 22% cases of acquired melanocytic nevus, 23.8% cases of plantar wart and 40% cases of sebaceous hyperplasia showed complete clearance. The most common adverse effect was post-laser erythema in 50.4% of cases, followed by pain in 36.8%. Besides this, scarring and dyspigmentation were observed in 11.6% and 12% of cases, respectively. The rate of recurrence on 3 months follow-up was 9 (23.07%) cases in xanthelasma palpebrarum, 11 (28.9%) cases in seborrheic keratosis, 10 (23.8%) cases in verruca plana and 9 (42.8%) cases in plantar warts.

Conclusion:
This study suggested that erbium-YAG ablation achieved good results for superficial lesions like verruca plana, seborrheic keratosis, xanthelasma palpebrarum, plantar wart, sebaceous hyperplasia and acquired melanocytic nevus. Thus, Er: YAG laser can offer a one-step procedure with better cosmetic results and a lesser rate of recurrence.
Cardiac Dysautonomia, Decreased Baroreflex Sensitivity and Increased Myocardial Workload in Patients with Chronic Spontaneous Urticaria
Authors: Ferdous Suraiya , Rajasegaran Rajalakshmi , Munisamy Malathi , Basu Sharbari , Harichandrakumar KT 
Published: August 2024

Background:
Chronic stress, a potential risk factor for cardiac autonomic dysfunction and cardiovascular (CV) risk, is known to induce the onset and exacerbation of chronic spontaneous urticaria (CSU), a psychodermatological disorder. However, data regarding CV risks due to the stress associated with CSU are very limited.

Aims and Objectives:
This study aimed at comparing the cardiac sympathovagal balance (SVB), inflammatory markers, perceived stress and quality of sleep in patients with CSU (test group) and normal subjects (control group). In addition, it also aimed at assessing the correlation between the SVB and other study parameters in individuals with CSU.

Materials and Methods:
Thirty-four patients with CSU and twenty-eight age- and gender-matched healthy controls were recruited for the study. Heart rate variability (HRV), baroreflex sensitivity (BRS) and biochemical markers of stress and inflammation (s-cortisol, interleukin (IL)-6, IL-18 and high sensitivity C-reactive protein (hs-CRP)) were assessed following standard procedures. Perceived stress and sleep quality were assessed using pre-validated questionnaires. Study parameters were compared between the test and control groups using the independent-samples Student's t-test or Mann–Whitney U-test. The correlation between SVB and other study parameters was assessed using Spearman's rank correlation coefficient test. P < 0.05 was considered statistically significant.

Results:
Levels of perceived stress, inflammatory markers, mean arterial pressure (MAP), myocardial workload (rate pressure product (RPP)), and HRV indices indicative of cardiac sympathetic activity were significantly high in individuals with CSU. In contrast, BRS and HRV indices indicative of parasympathetic activity and sleep quality were significantly low in these individuals. There was no significant correlation between SVB and other study parameters.

Conclusions:
Patients with CSU have cardiac dysautonomia characterised by increased sympathetic activity and decreased parasympathetic activity. Also, the reduced BRS and increased RPP point towards an increased risk of CV morbidity in these individuals.
A Proposal for the Etiopathogenesis of Acquired Cold Urticaria
Authors: Çaytemel Ceyda , Türkoğlu Zafer , Ağırgöl Şenay , Ustaoğlu Eda , Demir Filiz T. , Uzuner Esen G. 
Published: August 2024

Background:
The etiopathogenesis and cold stimulation mechanism are not fully understood in cold urticaria (CU). Substance P (SP) is released from skin neurons as a result of cold stimulation. It causes mast cell degranulation and therefore causes mast cell chymase (MCC) release. Angiotensin-converting enzyme (ACE) plays a role in removing SP from the environment. ACE also catalyses the conversion of angiotensin I (AT1) to angiotensin II (AT2), like MCC. This study aims to investigate the role of SP, ACE and MCC in the pathogenesis of CU.

Methods:
Patients with acquired CU were included in the study. Two punch biopsies were taken from the urticaria plaque resulting from the stimulation and the intact skin without lesions. The samples were evaluated histopathologically. All samples were stained immunohistochemically with SP, ACE and MCC antibodies.

Results:
The number of patients included in the study was 21. In the plaque lesion, the presence of dermal neutrophil and eosinophil, neutrophil in the vascular lumen were found to be statistically significantly higher than intact tissue (p = 0.046, P = 0.014, P = 0.014). Strong positive staining was detected in the full thickness of the epidermis, vascular endothelial cells, eccrine and sebaceous glands with ACE. MCC was statistically significantly higher in lesional skin than lesion-free skin samples (p < 0.001).

Conclusions:
Mast cell maintains its central role in CU pathogenesis. SP, which causes neurogenic inflammation, may not be detected due to its rapid destruction in the tissue. Strong staining of ACE, which takes part in the local renin-angiotensin-aldosterone (RAS) system in the skin, should be documented quantitatively.
Secondary Cutaneous Mucormycosis Post-COVID-19
Authors: Abhirami B , Kumar Prabhat , Mishra Dharmendra Kumar , Yadav Satyendra Prasad 
Published: August 2024

Background:
Mucormycosis is an angioinvasive mucorales fungal infection. Cutaneous type formed 10.5% of cases in India in precovid-19 era. Glucocorticoid-induced immunosuppression and hyperglycemia, reusable oxygen humidifiers in COVID-19 therapy, and preexisting uncontrolled diabetes mellitus contribute to post-COVID-19 mucormycosis. However, for post-COVID-19 cutaneous mucormycosis, sufficient data is not available.

Aim:
To study factors related to post-COVID-19 cutaneous mucormycosis.

Methodology:
Clinical and investigation details of six patients admitted in tertiary center with post-COVID-19 cutaneous mucormycosis.

Results:
Among six patients, three were males and three females; all in 45–60 years age group from districts under tertiary center. Site of eschar was face (four) and lips (two). All six were positive for COVID-19 10–12 days prior to admission for mucormycosis. All had intravenous steroids and supportive humidified oxygen therapy for minimum 1 week under COVID-19 treatment. They presented to emergency with ophthalmic/ENT complaints; subsequently, they developed cutaneous manifestations within 2–3 days. All six had diabetes mellitus, with above 400 mg/dL sugar levels at admission.

Conclusion:
This study's findings correlated with various studies across the country and elsewhere. Preexisting diabetes mellitus and steroid therapy for COVID-19 increase the risk of mucormycosis. Caution for early diagnosis, maintaining blood glucose levels, and judicious use of steroids for treatment of COVID-19 are indicated.
Detection of the Safe Zone for Upper Eyelid Hyaluronic Acid Injections
Authors: Can Bilgen , BetülGözel  
Published: August 2024

Background:
Hyaluronic acid (HA) injections for upper eyelid volumisation are safe procedures with short downtime and low complication rates. Nevertheless, the upper eyelid is a high-risk area for vascular complications because of its rich vascular network. After injection, bruising, an indicator of vascular penetration, develops very often and prolongs the short downtime.

Aims:
To describe a pain-controlled withdrawal technique for minimizing vascular complications and to examine the effects of topical anaesthesia administered prior to injection on complications related to vascular penetration.

Methods:
HA was injected into the upper eyelids of 25 patients using the pain-controlled withdrawal technique without topical anaesthesia. The patients’ median age, complication rates, average amount of HA administered, and follow-up periods were evaluated. In addition, the patients were asked to evaluate their pain during injection using a numerical pain rating scale.

Results:
The patients’ mean age was 40.4 ± 7.3 years. Minimal eyelid edema developed in all patients but did not prevent any of the patients’ social activities. No bruising was detected in any of the patients, and no major vascular complications, such as blindness or cerebrovascular events, developed. The average amount of HA administered was 1.43 ± 0.45 cc. All patients evaluated their pain during injection as mild.

Conclusions:
With the pain-controlled withdrawal technique, none of the patients had minor or major complications due to vascular penetration. The procedure was well tolerated by the patients. The detection of the safe injection zone allowed the administration of more than the standard/accepted 01 cc HA (up to 0.3 cc) from one point.
Spectrum of Mucocutaneous Reactions to COVID-19 Vaccination
Authors: Sil Abheek , Jakhar Deepak , Das Anupam , Jagadeesan Soumya , Aradhya Sujala Sacchidanand 
Published: August 2024

Background:
With the COVID-19 vaccination taking stride all across the globe, there are multiple reports of vaccine-induced adverse reactions (cutaneous and systemic).

Objectives:
To study the frequency and characteristics of mucocutaneous reactions to COVID-19 vaccines.

Methods:
An online questionnaire-based study was performed among the recipients of COVID-19 vaccines

Results:
Majority (73.6%) of the responders had received the Covishield vaccine (AstraZeneca-Oxford), while 26.4% had been vaccinated with Covaxin (Bharat Biotech-ICMR). One or more post-vaccination mucocutaneous effects were experienced in 87 (19.6%) participants. Vaccine-associated mucocutaneous changes were observed in 19.7% and 22.2% of individuals who received Covishield and Covaxin, respectively. Local injection site reaction was the predominant mucocutaneous finding, followed by urticarial rash, exacerbation of preexisting dermatoses, morbilliform rash, apthous ulcers, pityriasis rosea like eruption, telogen effluvium, herpes zoster, purpuric rash, erythema multiforme and others. Anaphylaxis was reported in three individuals. However, fatality was not reported in any of the vaccine recipients. Intergroup assessment of parameters with respect to type of vaccine was found to be insignificant.

Conclusion:
Majority reported mild and self-limiting reactions. This outcome should not discourage the common man in getting vaccinated.
A Retrospective Study of Demographic Profile and Management Appraisal Non-Gonococcal Urethritis in Male Patients Attending a Tertiary Care Hospital in Odisha
Authors: Dwari Binayak Chandra , Patro Nibedita , Bhatt Mamata , Tripathy Nalini 
Published: August 2024

Background:
Male urethritis is primarily sexually transmitted in India and has also shown a high rate. Urethritis or inflammation of the urethra is a multifactorial condition. It is called gonococcal urethritis (GU) when Neisseria gonorrhoeae is detected in a urethral smear of the patient and non-gonococcal urethritis (NGU) when this organism cannot be visualized.

Aims and Objectives:
To study the demographic profile and management pattern of NGU retrospectively in male patients.

Materials and Methods:
Urethritis cases were identified from the dermatology outpatient record. A retrospective study of data of patients diagnosed with NGU was done for 5 years from August 2015 to July 2020. We included only male patients more than 10 years of age.

Results:

Chlamydia trachomatis (CT, 48%) was the most common causative organism found. The diagnosis was confirmed by demonstrating ≥5 polymorphonuclear lymphocytes (PMNLs) from the anterior urethra using a Gram-stained urethral smear followed by the polymerase chain reaction (PCR.) of urine. The most common age group affected was 21

–
30, (30, 46%) years with a mean ± standard deviation (SD) of 30.32 ± 10.80. Most patients were from low socioeconomic status, labourers (36, 55%). A history of heterosexual behaviour, (57, 88%) was the most common and it had been seen that sexual exposure was more common in unmarried patients (38, 59%). Associated features were seen in 18 patients. Among recommended initial therapies for NGU, doxycycline and azithromycin might be improved by the addition of antimicrobial coverage for Trichomonas vaginalis (T. vaginalis). Further, it was seen that response to doxycycline therapy was better than azithromycin.

Conclusions:
Though there is an increased incidence of Herpes infections, we found Chlamydia infection to be the most common cause of NGU. Doxycycline showed better results in NGU due to Chlamydia infection.
Serum Leptin and Adiponectin
Authors: Yan Haoxiang , Yu Bei , Tian Jinlan , Xia Dengmei , Xu Yang , Li Changqiang 
Published: August 2024

Background:
To explore the role and clinical significance of serum adiponectin and leptin levels in patients with psoriasis accompanied by atherosclerosis.

Methods:
Eighty patients diagnosed with psoriasis in our dermatology department and 40 healthy people in our physical examination centre were included as the study group and control group, respectively. All the included patients underwent fasting blood and serum tests. Levels of adiponectin, leptin, and the blood lipid content; colour Doppler ultrasonography of both common carotid arteries, internal carotid and external carotid arteries; and intimal-medial thickness (IMT) and carotid plaque were evaluated.

Results:
In the study group, the leptin level increased, and the serum adiponectin level decreased; these levels were statistically significantly different compared with those in the control group (t = 6.774, P < 0.001 and t = –3.511, P < 0.05, respectively). IMT was negatively correlated with adiponectin levels (r = –0.378, P < 0.001) and positively correlated with leptin levels (r = 0.581, P < 0.001).

Conclusions:
The imbalanced expression of serum and adiponectin levels will aggravate psoriasis and promote the occurrence of atherosclerosis. Serum levels can be used to assess the disease severity, detect vascular lesions early, and prevent the development of psoriasis to cardiovascular disease.
Anal Canal Condyloma Acuminatum Treated with Anti-HPV Biological Dressing
Authors: Hu Yanyan , Li Meihua , Liu Jing , Huang Qian , Chen Jinbo , Chen Liuqing , Li Dongsheng 
Published: August 2024

Background:
Anal canal condyloma acuminatum (CA) is a refractory disease with a high recurrence rate caused by human papillomavirus (HPV). Multiple clinical trials demonstrate that anti-HPV biological dressing is safe and effective in treating HPV infection, which has been used in treating high-risk HPV-positive and cervical intraepithelial neoplasia I (CIN I) patients. Yet, there is still a lack of clinical data for the treatment of anal canal CA.

Aims and Objectives:
To evaluate the clinical efficacy and application value of anti-HPV biological dressing in anal canal CA.

Materials and Methods:
Taken currently recommended treatment 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) as a positive control, 128 patients were included with 64 in each group, and a prospective, randomized, positive controlled, non-inferiority clinical trial was conducted. After removing visible skin lesions with conventional microwave, the treatment group was given anti-HPV biological dressing, while the control group received the conventional ALA-PDT treatment. Patients were followed up on the 1st, 12th and 24th weeks after the treatment. The cure rate, recurrence rate, HPV-negative conversion rate, and adverse events were recorded.

Results:
In the 1st, 12th and 24th weeks after treatment, the cure rate, recurrence rate and HPV-negative conversion rate of the treatment group and the control group showed no statistically significant difference. In the treatment group, 56 patients developed transient mild itching and all were relieved spontaneously, while in the control group, most of the patients experienced obvious pain and some patients needed symptomatic treatment. No severe systemic adverse events were observed.

Conclusion:
Compared with ALA-PDT, topical application of anti-HPV biological dressing has comparable promising outcomes in the treatment of anal canal CA, with fewer side effects and simpler operation making it suitable for clinical applications.
Analysis of Serum Immunoglobulin G (IgG) Levels against Toxoplasma Gondii, Herpes Simplex Virus Types 1 and 2, Cytomegalovirus and Hepatitis C Virus in Vitiligo
Authors: Ribeiro Rachel de Paula , Lacerda Kenia A. P. , Guillo Lídia A. 
Published: August 2024

Background:
Pathogen infections have been associated with autoimmunity, which in turn has been implicated in the pathogenesis of vitiligo. However, the association between pathogen infections and vitiligo remains elusive.

Aims:
This study aimed to assess the proportion of individuals who tested positive for specific IgG antibodies against selected pathogens in patients with vitiligo and control subjects.

Materials and Methods:
Plasma from 51 patients with vitiligo and 51 age- and gender-matched controls were tested for anti-Toxoplasma gondii (T. gondii) IgG, anti-herpes simplex types 1 and 2 (HSV-1/2) IgG, anti-cytomegalovirus (CMV) IgG and anti-hepatitis C virus IgG.

Results:
Among all participants (n = 102), 63%, 84% and 87% tested positive for anti-T. gondii, anti-HSV-1/2 and anti-CMV IgG antibodies, respectively. Anti-hepatitis C virus IgG was negative in all samples tested. Positive anti-T. gondii IgG was detected in plasma samples of 39 (78%) patients with vitiligo and 25 (49%) controls (odds ratio [OR] 3.68, 95% confidence interval [CI] 1.55–8.76, P = 0.0036). Anti-HSV-1/2 IgG was detected in samples of 47 (92%) patients with vitiligo and 38 (76%) controls (OR 3.71, 95% CI 1.11–12.44, P = 0.031). Differences in frequencies of positive results for anti-T. gondii IgG and anti-HSV-1/2 IgG were only significant in samples from female patients with vitiligo when compared with controls (P = 0.036 and 0.024, respectively). Anti-CMV IgG was detected in samples from 46 patients with vitiligo (90%) and 41 (84%) controls (P = 0.384).

Conclusions:

T. gondii IgG and HSV-1/2 IgG were significantly more frequent in patients with vitiligo, especially in women, when compared with age- and gender-matched controls. Since T. gondii and HSV-1/2 infections can trigger autoimmune events, past exposure to these pathogens may be a risk factor for the development of vitiligo.