bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
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.
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.
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.