bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Study of Cutaneous Adverse Drug Reactions and their Association with Autoimmune Diseases at a Tertiary Centre in South-West Rajasthan, India
Authors: Rana Shweta , Gupta Kalpana , Agarwal Nidheesh , Ahamed Ahamed Noor Mqnsoon 
Published: May 2024

Background:
Cutaneous adverse drug reactions (CADRs) comprise about 30% of all adverse drug reactions and observed in 2–3% of hospitalized patients by wide variety of offending agents.

Aims:
To study the clinical patterns, causative drugs and their association with autoimmune diseases in CADR patients.

Materials and Methods:
A total of 174 CADR patients who presented to the dermatology OPD over a period of 18 months (1 July 2015 to 31 Dec 2016) were considered for the study. Detailed history, clinical examination, hematological, and biochemical investigations were recorded. The venereal disease research laboratory test, HIV (ELISA), and histopathological examination were done wherever indicated.

Results:
The mean age of the patients with cutaneous drug eruptions was 40.2 years. Most of them (31.0%) were in the age group of 41–50 years. There were 93 (53.4%) males and 81 (46.5%) females with the M:F ratio of 1.5:1. The most common eruption observed was maculopapular rash in 33.3% followed by fixed drug eruption (17.2%) and lichenoid dermatitis' (11.5%). The drugs most commonly responsible for CADRs were antimicrobials (n = 68, 39%) with fixed dose combination of fluoroquinolones with nitroimidazoles (n = 42). We also noticed that a total of 42 patients out of 174 had comorbities in the form of diabetes (n = 27, 15.5%), hypothyroidism (n = 9, 5.1%), rheumatoid arthritis (n = 3, 1.7%), vitiligo (n = 2, 1.1%), and SLE (n = 1, 0.5%).

Conclusion:
Cutaneous ADR patterns and the drugs causing various reactions are changing every year, which may be because of the introduction of newer molecules and changing trends in the use of drugs. In our study, a significant relation of CADRs with autoimmune diseases (P value = 0.004) was also observed.
A Cross Sectional Survey for Dermatoses in Children and Adolescents Residing in Orphanages in Urban Tirunelveli, Tamil Nadu, India
Authors: Palanivel Nirmaladevi , Govardhanan Vijaikumar Manikka , Moorthi Soundharyaa Savada , Maalik Babu A. N. M. , Kannan S. M. 
Published: May 2024

Context:
Skin diseases are a major cause of public concern among underprivileged people residing in orphanages. There is a need for community-based study for dermatoses in orphanages as the literature is scarce at the national and international levels.

Aims:
For profiling of various dermatoses to generate information on general health, nutritional status, and sanitation, and to educate about personal skin hygiene and care to inmates in urban child orphanages.

Settings and Design:
A cross-sectional study was conducted at 18 urban child orphanages in Tirunelveli city for 1 month.

Methods and Material:
A predesigned proforma was prepared and the demographic details regarding the inmates were obtained and they were screened under natural light for skin, hair, nail, and oral disorders as well as their built, nourishment, height, and weight were measured and recorded in tabulations.

Statistical Analysis Used:
Descriptive statistical analysis was followed for describing the prevalence of dermatoses and the age group affected which are explained in percentages and ratios.

Results:
Out of a total of 850 inmates, 93 (11%) were of 5–9 years and 757 (89%) were of 10–19 years. Among them, 330 (39%) were males and 520 (61%) were females. Overall, the inmates affected with dermatoses were 360 (42.4%) and infectious dermatoses were seen in 218 inmates (60.5%) and non-infectious dermatoses were seen in 142 inmates (39.5%). Adolescent females were more commonly affected and the commonest dermatoses observed were pediculosis capitis (13.6%) followed by acne vulgaris (8.1%) and in adolescent males, scabies (7.1%) was the commonest. No psychocutaneous disorders were encountered.

Conclusions:
Infections and infestations are common in orphanages due to a lack of awareness of personal hygiene and self-care practices. They should be given health education in order to reduce the disease burden in children living in orphanages which in turn decreases the disease burden at the community level.
Analysis of Alterations of the Gut Microbiota in Moderate to Severe Psoriasis Patients Using 16S rRNA Gene Sequencing
Authors: Wang Xiaomeng , Chen Zheng , Qiao Song , Zhu Qiming , Zuo Zongbao , Guo Birong 
Published: May 2024

Background:
Psoriasis is an inflammatory skin disease. The correlation between intestinal microbiota and immune-mediated diseases makes scientists pay attention to the pathogenic role of microbiota.

Objective:
The aim of this study was to identify the gut microbial composition of patients with psoriasis.

Methods:
16S rRNA gene sequencing method was used to analyse the faecal samples which was collected from 28 moderately severe psoriasis patients and 21 healthy controls and was followed by the analysing of informatics methods.

Results:
No visible differences can be observed in the diversity of gut microbiota between the psoriasis and the healthy patients, but the composition of the gut microbiota illustrate significant distinction between these two groups. At the phylum level, compared to the healthy control group, the psoriasis group shows higher relative abundance of Bacteroidetes and lower relative abundance of Proteobacteria (P < 0.05). At the genus level, unidentified_Enterobacteriaceae, unidentified_Lachnospiraceae, Romboutsia, Subdoligranulum, unidentified_Erysipelotrichaceae, Dorea were relatively less abundant in psoriasis patients, whereas Lactobacillus, Dialister were relatively more abundant in psoriasis group (all P < 0.05). LefSe analysis (linear discriminant analysis effect size) indicated that Negativicutes and Bacteroidia were potential biomarkers for psoriasis.

Conclusion:
This study identified the intestinal microecological environment of patients with psoriasis and healthy people, proving that psoriasis patients have a remarkably disturbed microbiome, and found several biomarkers of intestinal microorganisms in patients with psoriasis.
The Study of Serum Level of Interleukin-2, Interleukin-6, and Tumor Necrosis Factor-alpha in Stable and Progressive Vitiligo Patients from Sina Hospital in Tabriz, Iran
Authors: Ranjkesh Mohammad Reza , Partovi Mahya Rahimi , Pashazadeh Mehrdad 
Published: May 2024

Background:
Vitiligo is an acquired depigmenting disorder characterized by the loss of functional melanocytes from the epidermis. Although the etiology of vitiligo is unknown, over the last few years, substantial data from clinical research have greatly supported the "Autoimmune theory." Vitiligo has two major forms: progressive and stable. As cytokines are important mediators of immunity, the most important of them are IL-2, IL-6, and tumor necrosis factor-α (TNF-α).

Objectives:
We aimed to study the serum level of IL-2, IL-6, and TNF-α in stable and progressive vitiligo and compared them to find a useful lab test to determine the form of vitiligo for diagnose and treatment.

Materials and Methods:
Serum IL-2, IL-6, and TNF-α were done by the indirect enzyme-linked immunosorbent assay (ELISA) in 40 cases of stable and progressive vitiligo.

Results:
Twenty patients had progressive vitiligo and 20 patients were stable vitiligo. In every group, there were seven male patients. Twenty-one patients had a positive family history of vitiligo and four patients had other autoimmune diseases. The average age and familial history between two groups and two genders were not meaningful. The mean serum TNF-α level was significantly higher in progressive than stable vitiligo. No significant difference was observed in the serum levels of IL-2, IL-6 between stable and progressive vitiligo. The mean serum IL-6 and TNF-α had higher levels in male patients.

Conclusion:
Analysis of TNF-α levels in every age or gender can show us the type of vitiligo, stable or progressive and we can choose the best form of treatment for patients.
Efficacy and Safety of Adding Low-Dose Isotretinoin to Itraconazole in the Treatment of Chronic Recurrent Dermatophytosis among Sample of Iraqi Patients
Authors: Alhamdi Dooha K. , Alhamdi Khalil I. 
Published: May 2024

Background:
An increasing number of dermatophytosis is seen now in daily clinical practice, with unusual presentations, running a chronic recurrent course and seems to be more resistant to systemic and topical conventional treatments, which necessitate the use of other treatment options that help to cure these challenging clinical conditions such as isotretinoin along with itraconazole.

Objectives and Aim:
This is a prospective randomised open-label therapeutic comparative clinical trial to assess the efficacy and safety of low-dose isotretinoin along with itraconazole to treat and reduce the recurrence of this distressing chronic recurrent dermatophytosis.

Methods:
Eighty-one patients with chronic recurrent dermatophytosis with positive mycological examination were recruited, all of them received itraconazole for 7 days per month for 2 consecutive months duration; half of them were randomly chosen to receive low-dose isotretinoin every other day for 2 months in addition to itraconazole. All patients were followed up at monthly intervals for 6 months.

Results:
The patients who received isotretinoin along with itraconazole showed earlier and complete clearance in 97.5% with a significantly low recurrence rate (12.8%) in comparison with those who received itraconazole alone where the cure rate was relatively slower reported in 53.7% of the patients with a relapse rate of 68.1% with no significant side effects.

Conclusion:
Low-dose isotretinoin with itraconazole seems to be safe, effective and promising choice in the treatment of chronic recurrent dermatophytosis as it induced earlier complete cure with a significant reduction of recurrence rate.
Assessment of the Efficacy and Safety of 30% Supramolecular Salicylic Acid Peeling for Papulopustular Rosacea Treatment
Authors: Xu Linghui , Yao Boxin , Xu Tianxing , Huang Huang 
Published: May 2024

Background:
Thirty per cent supramolecular salicylic acid (SSA) is a water-soluble, sustained release salicylic acid (SA) modality, which is well tolerated by sensitive skin. Anti-inflammatory therapy plays an important role in papulopustular rosacea (PPR) treatment. SSA at a 30% concentration has a natural antiinflammatory property.

Aims:
This study aims to investigate the efficacy and safety of 30% SSA peeling for PPR treatment.

Methods:
Sixty PPR patients were randomly divided into two groups: SSA group (30 cases) and control group (30 cases). Patients of the SSA group were treated with 30% SSA peeling three times every 3 weeks. Patients in both groups were instructed to topically apply 0.75% metronidazole gel twice daily. Transdermal water loss (TEWL), skin hydration and erythema index were assessed after 9 weeks.

Results:
Fifty-eight patients completed the study. The improvement of erythema index in the SSA group was significantly better than that in the control group. No significant difference was found in terms of TEWL between the two groups. The content of skin hydration in both the groups increased, but there was no statistical significance. No severe adverse events were observed in both the groups.

Conclusion:
SSA can significantly improve the erythema index and overall appearance of skin in rosacea patients. It has a good therapeutic effect, good tolerance and high safety.
Serum Soluble Intercellular Adhesion Molecule-1 (sICAM-1)
Authors: Mustafa Amany Ibrahim , Ebrahim Adel Ali , Abel Halim Waleed Abdel Lateef , Fawzy Eman , Abdou Ahmed Fathy 
Published: May 2024

Background:
Acne vulgaris (AV) is a chronic inflammatory disorder. Intercellular adhesion molecule-1 (ICAM-1) is a vital adhesion molecule mediating cellular adhesion during the inflammatory process.

Aims and Objectives:
To evaluate serum soluble intercellular adhesion molecule-1 (sICAM-1) level in AV patients as an attempt to elucidate its role in acne pathogenesis and to relate with studied clinical parameters.

Materials and Methods:
Serum sICAM-1 level was measured using ELISA technique in 60 patients and 60 controls.

Results:
Serum sICAM-1 level was significantly elevated in studied patients than controls (P < 0.001). Additionally, its level increased significantly with increased acne severity (P < 0.001) but not in patients with post acne scars (P > 0.05).

Conclusion:
Serum sICAM-1 could be a marker for acne etiopathogenesis. Furthermore, it might be considered as a predictor for disease severity.
Comparative Effectiveness and Safety of Methotrexate Versus PUVA in Severe Chronic Stable Plaque Psoriasis
Authors: Banerjee Saikat , Das Suchibrata , Roy Alok K , Ghoshal Loknath 
Published: May 2024

Background:
Psoriasis is a chronic, inflammatory, immune-mediated, debilitating skin disease affecting approximately 2%–3% of the global population. Various treatment modalities are available for extensive psoriasis which include methotrexate, cyclosporine, retinoids, oral PUVA therapy, and biologic agents.

Aims and Objectives:
The aim of this study was to compare the effectiveness and safety of methotrexate vs. PUVA in severe chronic plaque psoriasis with BSA >20%.

Materials and Methods:
A randomized open-label clinical study was performed. Sixty patients with extensive stable plaque psoriasis were recruited in the study. Thirty patients received methotrexate at a dose of 0.4 mg/kg up to a maximum of 15 mg/week and the rest 30 were treated by PUVA, 8-methoxy psoralen tablet (20 mg) followed by UVA started at the dose of 1 j/cm2 thrice weekly with an increment of 20% dose every third sitting until 2.5 j/cm2 is reached. Both forms of treatment were continued for 10 weeks or until PASI 90 achieved, which-ever was earlier. Clinical examination, blood investigation, PASI scoring, and photograph were repeated in serial intervals during the study. At the end of study, the data were compiled, tabulated, and analyzed.

Result:
In the PUVA group, 90% achieved PASI-50 and 63.33% achieved PASI-90, in the methotrexate group all patients achieved both PASI-50 and PASI-90. Methotrexate acted significantly faster than PUVA in disease clearance. In the methotrexate group decreased platelet count in 13.33% patients, decreased hemoglobin (<10 gm/dl), elevated liver enzyme, each of these developed in 10% of patients. In the PUVA group, no serious side effects were observed.

Conclusions:
Methotrexate is more efficacious with lesser incidence of subjective complications and more incidence of laboratory complications compared to PUVA in extensive plaque psoriasis.
Clinico-Epidemiology and Histopathologic Spectrum of Primary Scarring Alopecia
Authors: Sardar Souvik , Sarkar Somenath , Podder Indrashis , Banerjee Gautam 
Published: May 2024

Background:
Primary scarring alopecias (PSAs) are a rare group of dermatological disorders with overlapping clinical features. They result in permanent hair loss and significant psychological morbidity.

Aims:
To analyze the clinico-epidemiology of PSAs of the scalp, along with clinico-pathological correlation.

Methods:
We conducted a cross sectional, observational study including 53 histopathologically confirmed cases of PSA. Clinico-demographic parameters, hair care practices, and histologic characteristics were noted and statistically analyzed.

Results:
Among 53 patients (mean age 30.9 ± 8.1 years, M: F 1:1.2, median duration 4 years) with PSA, lichen planopilaris (LPP) was most common (39.6%, 21/53), followed by pseudopelade of Brocq [30.2%, 16/53], discoid lupus erythematosus (DLE) [16.9%, 9/53], and non-specific scarring alopecia (SA) (7.5%, 4/53), while central centrifugal cicatricial alopecia (CCCA), folliculitis decalvans, and acne keloidalis nuchae (AKN) accounted for 1 case each. Forty-seven patients (88.7%) demonstrated predominant lymphocytic inflammatory infiltrate, while basal cell degeneration and follicular plugging were the commonest histological changes. Perifollicular erythema and dermal mucin deposition were noted in all patients with DLE (both P < 0.05). Nail involvement (P = 0.004) and mucosal involvement (P = 0.8) were more common in LPP. Single alopecic patches were characteristic of DLE and CCCA. Hair care practices (non-medicated shampoo > oil) had no significant association with the subtype of PSA. (P = 0.4)

Conclusion:
PSAs are a diagnostic challenge for dermatologists. Thus, histology and clinico-pathological correlation should be performed in all cases for proper diagnosis and treatment.
Clinical Spectrum of Cutaneous Malignancies in Central India
Authors: Supekar Bhagyashree Babanrao , Tomar Suyash Singh , Wankhade Vaishali H. , Bhushan Ravi , Singh Rajesh Pratap , Bhat Dharitri Mukund 
Published: May 2024

Introduction:
Cutaneous malignancies account for 1%–2% of all the diagnosed cancers in India. Nonmelanoma skin cancers (NMSCs) include basal cell carcinomas (BCC) and squamous cell carcinomas (SCC). Others include melanoma, cutaneous lymphomas, and sarcomas. Exposure to ultraviolet (UV) rays is the most important risk factor associated with skin malignancies, although various other factors are also implicated.

Aims and Objectives:
The aims of this work were to study clinical spectrum with age and sex distribution of cutaneous malignancies and metastasis; to study clinicopathological variants of each type of cutaneous malignancies; and to study the risk factors associated with cutaneous malignancies.

Patients and Methods:
It was a retrospective analysis of clinically and biopsy proven cases of cutaneous malignancies from January 1, 2016 to January 31, 2018. Medical records of patients were assessed with respect to demographic information, clinical examination, dermoscopy, and histopathology. Statistical analysis was done using mean, proportion, and percentage.

Results:
Sixty-six cases with cutaneous malignancies were recruited. There was female preponderance. The most common age group affected was 60–70 years. BCC was the most common malignancy (41%) followed by SCC (30%), malignant melanoma (9%), and cutaneous T-cell lymphoma (1.5%). Head and neck was the most common site involved. The most common clinical type of both BCC and SCC was the nodular type. Acral lentiginous was the most frequent subtype of melanoma reported. The most common predisposing for NMSCs was prolonged sun exposure (46%).

Conclusion:
This study highlights an increasing trend of NMSCs with female preponderance. Head and neck is the most common site involved. Increased risk of NMSCs is seen with increased sun exposure and predisposed genetic conditions. T-cell lymphoma was common than B-cell type. The most common internal malignancy to cause cutaneous metastasis was breast carcinoma.
Clinical Effects of BNT162b2 Vaccine on the Short-Term Course of Chronic Spontaneous Urticaria Patients
Authors: Tuzer Can , Sezer Suat 
Published: May 2024

Background:
The clinical effects of Pfizer-BioNTech coronavirus disease 2019 (COVID-19; BNT162b2) vaccine on the clinical course of chronic spontaneous urticaria (CSU) is unclear.

Aims and Objectives:
To evaluate the clinical effects of BNT162b2 vaccine on the clinical course of CSU.

Methods:
In this study, 90 CSU patients vaccinated with one or two repeated doses of BNT162b2 vaccine were included. Urticaria Activity Score over 28 days (UAS28), Urticaria Control Test (UCT), Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL), and Medication Scores (MSs) were obtained before the vaccination, 28 days after the first and, if available, after the second dose of BNT162b2 vaccine. The demographic, clinical, and laboratory features were compared between the subjects with exacerbated (group A) and non-exacerbated (group B) disease activity.

Results:
Among the 90 study participants, 14 (15.5%) experienced exacerbations in their urticarial activity after the first or repeated doses of BNT162b2 vaccinations. The demographic, clinical, and laboratory features were similar between the exacerbated and non-exacerbated CSU patients. However, the rate of adverse reactions within 48 hours, such as hives, injection site reactions and wheals lasting <1 hour, were significantly higher in group A than in group B (P = 0.004, P < 0.001, P = 0.001, P = 0.018).

Conclusions:
BNT162b2 vaccination caused an exacerbation in 15.5% of CSU patients during the short-term follow-up. The long-term evaluation can be informative about the lasting effects of BNT162b2 vaccine on the clinical course of CSU patients.
Intravenous Immunoglobulin
Authors: Vaishampayan Sanjeev S. , Bhati Surendra Singh , Lachhiramani Radha R. , Shrivastava Shivank , Jain Prateek , Raghuwanshi Ajay Singh 
Published: May 2024

Background:
Many a times while treating dermatoses conventional therapies are either contraindicated or not effective. Intravenous immunoglobulin (IVIG) is a good alternative available to tide over crises.

Method:
Over the last 15 years of my practice I have used IVIg in various severe or recalcitrant diseases (including TEN, autoimmune blistering disease, connective tissue disorders, chronic urticaria etc) which were either unresponsive to conventional modality of therapy or primary therapy could not be given because of co-morbidities.

Result:
IVIg a sterile, highly purified preparation containing more than 95% unmodified IgG, was first approved by FDA in 1981 for 6 diseases. As mentioned above in many circumstances we reached a situation when either conventional primary therapy was contraindicated or patients were not responding. IVIg came to our rescue in large number of conditions to tide over the crisis and also created the environment leading to conventional therapy becoming effective. Very few minor side effects like low grade fever and myalgia were observed in very few cases. No serious or severe side effects were seen, however, one has to be prepared for anaphylactic reaction which is a theoretical possibility.

Conclusion:
It can be said that IVIg though not a magic drug, is a very effective tool available in the armamentarium of Dermatologists to treat plethora of chronic and intractable dermatoses.
Patch Testing as a Corroborative and Diagnostic Tool in Patients Suspected of Contact Allergen Induced Facial Melanosis
Authors: Ghuse Vedant M. , Someshwar Shylaja 
Published: May 2024

Background:
Hypermelanosis involving predominantly the face and neck is relatively common and often presents a complex diagnostic problem.

Objective:
To study the patterns of facial melanosis in Indian skin and assess the importance of patch testing as a corroborative tool in the diagnosis of facial melanosis.

Subjects and Methods:
A total of 50 patients who consented to the study and satisfied the inclusion and exclusion criteria were incorporated in the study. These patients were subjected to a detailed history, clinical, dermoscopic, and histopathological evaluation. Patch testing using the universal series, cosmetic series, and photopatch was done on those who satisfied the inclusion criteria. Suspected allergen "as is" patch testing was done in selected cases.

Results:
Facial melanosis as a result of contact dermatitis is a common entity and was seen in the age group of 18–70 years in both the sexes with male to female ratio of 6.5:2.5 indicating a male preponderance. The most common dermoscopic finding was the presence of reticular pigment network seen in 33 (66%) cases. Histopathology showed increased basal melanin in 56% and pigment incontinence in 26% of the cases. The commonest allergen in men was found to be potassium dichromate (15%), while in females it was nickel (20%). Photopatch test was done for all the patients and was positive in five cases (10%). Suspected allergen "as is" patch testing was negative in all the cases.

Conclusions:
Facial melanosis as a result of contact dermatitis can be confused with other acquired dermatological conditions causing hyperpigmentation. Therefore, a detailed history of contact with allergens has to be elicited, and if found relevant, has to be confirmed by patch testing.