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International Journal of Research in Dermatology
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2455-4529
Published by Medip Academy Homepage  [12 journals]
  • Change in profile of cutaneous manifestations of HIV after the advent of
           antiretroviral therapy: a retrospective analysis

    • Authors: Ireen C. Bwalya, Som Lakhani, Christian Aldridge
      Pages: 755 - 764
      Abstract: Background: To date, there has been no study conducted in Zambia to determine the prevalence of mucocutaneous conditions among HIV positive patients on antiretroviral therapy.Methods: The aim of the study was to determine the differences in cutaneous manifestations of HIV between HIV positive adult patients on antiretroviral therapy and antiretroviral naïve patients.Results: A total of 143 adult HIV/AIDS patients with dermatological manifestations, and fulfilling inclusion criteria, were included. Among the 58 patients on antiretroviral therapy, the most common dermatoses were hyper-pigmentation (18.97%), fungal dermatitis (17.24%) genital herpes (8.62%), papular pruritic eruption (8.62%), oral candidiasis (8.62%) and Kaposi’s sarcoma (6.9%). The most common dermatoses among the 85 antiretroviral naive patients were oral candidiasis (34.12%), herpes Zoster (17.65%), hyper pigmentation (8.24%), eosinophillic folliculitis (7.06%), abscesses (5.88%), herpes labialis (4.71%) and Kaposi's sarcoma (4.71%). Among patients in Stage III of HIV infection, the proportion of patients with infectious dermatoses was significantly greater than the proportion of patients with non-infectious dermatoses (47.5% versus 28.6%; p=0.036).The odds of having an infectious dermatosis were 28% lower for patients on antiretroviral therapy as compared to antiretroviral naive patients (p=0.001).Conclusions: There is a changing profile of muco-cutaneous conditions in HIV infected patients. Infectious dermatoses such as oral candidiasis and Herpes Zoster infections occur more frequently in antiretroviral naïve patients, as compared to patients on ART. Prevention of infectious dermatological conditions occurs with the use of ART.
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214198
      Issue No: Vol. 7, No. 6 (2021)
  • Profile of mean platelet volume, neutrophil - lymphocyte ratio and
           platelet - lymphocyte ratio in patient with psoriasis

    • Authors: Fatema Khatun, Zakir Ahmed, Harasit K. Paul, Zinat Amin, M. S. Z. Chowdhury
      Pages: 765 - 770
      Abstract: Background: Psoriasis is a chronic, inflammatory, systemic disease. In response to therapy in psoriasis patients, the psoriasis area severity index (PASI) is used to evaluate the disease activity. However more objective laboratory tools should be developed besides PASI. In various inflammatory diseases, mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLR), and platelet lymphocyte ratio (PLR) are inflammatory biomarkers that are known to be evaluated. The aim of the study was to assess the frequency of platelet activation and leukocyte infiltration by measuring MPV, NLR, and PLR.Methods: This was a case-control observational study conducted at department of dermatology and venereology at Bangabandhu Sheikh Mujib Medical University from July 2016 to December 2017. A total of 55 psoriasis cases and 55 healthy controls were included according to inclusion and exclusion criteria.Results: We have investigated a total of 55 psoriasis patients and another 55 age-sex matched control. There were 31 males (56.36%) and 24 females (43.44%) psoriasis patients in the study. The mean age of the patient was 34.27±13.44 years. Mean±standard deviation (SD) value of MPV, NLR, and PLR in our study cases were 9.92±1.21, 4.32±8.53, and 292.96±88.80 whereas in the case of control values were 9.46±0.636, 4.54±8.51, and 162.26±103.38 respectively.Conclusions: In conclusion, we suggest MPV is a strong indicator of psoriasis severity. MPV and PLR should be followed up routinely to take preventive measures against psoriasis-related micro and macro vascular thrombotic complications.
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214199
      Issue No: Vol. 7, No. 6 (2021)
  • Clinical assessment of novel plant-based moisturizer “Elovera” in
           management of dry skin conditions

    • Authors: Gaurav Anil Deshmukh, Dhiraj S. Dhoot, Hanmant Barkate
      Pages: 771 - 775
      Abstract: Background: Moisturizers are major component of basic daily skin care in patients with eczema/dermatitis. Botanical ingredients like aloe vera extract having anti-inflammatory property can be useful in reducing signs and symptoms along with improvement in dry skin in such patients.Methods: It was retrospective data analysis conducted across 145 centres in India. Patients with eczema/dermatitis who were prescribed Elovera a novel plant-based moisturizer were included in the study. Effectiveness was assessed by evaluating improvement in DASI score, physicians, and patients’ global assessment of disease. Safety was assessed by monitoring all the adverse events reported by the patients.Results: 402 patients were included in the study. There was significant improvement in mean baseline DASI score with with a reduction of 40.57% and 84.8% at week 2 and week 4, respectively. 86.31% (n=347) and 85.32% (n=343) patients reported significant improvement in their disease as per physician’s and patients’ global assessment of disease. Elovera was well tolerated and only 5 patients reported mild irritation and erythema during treatment.Conclusions: The result of our study proves that “Elovera” a novel plant-based moisturizer is associated with significant improvement in dry skin, signs, and symptoms of patients with eczema/dermatitis. Based on these results concomitant use of Elovera can be considered along with standard treatment for better outcome in patients with eczema/dermatitis.  
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214034
      Issue No: Vol. 7, No. 6 (2021)
  • Evaluation of serum 25-hydroxy vitamin D levels in alopecia areata of
           scalp: a cross sectional observational study

    • Authors: Manish Jain, Devendra Kumar Yadav, Asha Nyati, Mohan Lal
      Pages: 776 - 781
      Abstract: Background: Alopecia areata (AA) is a T cell-mediated autoimmune disorder of anagen hair follicle leading to distressing and relapsing non-scarring hair loss. Vitamin D an immunomodulator plays important role in regulating normal hair cycle. Recent evidence suggests inconsistent association between vitamin D deficiency and alopecia areata.Methods: Hospital-based cross-sectional observational study of forty untreated cases of alopecia areata and forty age and sex-matched healthy controls in 18-45 years of age group recruited from out-patient department. Each patient will undergo a detailed history, clinical examination and SALT (Severity of alopecia tool) scoring. Enhanced chemiluminesence method (Eci) will be used to estimate serum 25-hydroxy vitamin D [25(OH)D].Results: The mean 25(OH)D level in patients of AA was 12.45±4.80 ng/ml (deficient), while that of controls was 33.73±10.02ng/ml (normal). The difference between the levels of 25(OH)D in patients of AA and controls came out to be statistically significant (p≤0.0001). A strong negative correlation was seen between SALT score and 25(OH)D level (-0.32), which was found to be statistically significant (p=0.0462).Conclusions: The present study established that vitamin D levels are either insufficient/deficient in alopecia areata and it correlates negatively with severity of SALT (severity of alopecia tool) score.
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214200
      Issue No: Vol. 7, No. 6 (2021)
  • Profile of alopecia areata in patients attending dermatology out patient
           department in a tertiary care hospital in Gangtok, Sikkim

    • Authors: Nisha Gupta, Rekha Sharma, Rukma L. Sharma
      Pages: 782 - 786
      Abstract: Background: Alopecia areata is a condition that is characterized by a well-defined round or oval patches of non-scaring hair loss in scalp or any hairy area of the body. Alopecia areata has become a major health problem faced by people all over the world. This research was done to ascertain the prevalence of alopecia areata in different age group and to study its association with autoimmune diseases and systemic illnesses.Methods: The present hospital based descriptive study includes 52 alopecia areata patients attending dermatology out-patient department.Results: It was seen that the disease can occur at any age group mostly affecting those between 21-40 years. The age of presentation varied from 14 to 48 years with male preponderance. It was found that arthritis was associated in 30.7%, ANA was positive in 7.7% and 12% had hypothyroidism. Eosinophilia was found in 34.6% and 7.7% had asthma among then.Conclusions: Our study shows that it could be associated with autoimmunity, thyroid abnormality, atopy and inflammation.
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214201
      Issue No: Vol. 7, No. 6 (2021)
  • Dermatological manifestations in COVID-19 positive patients in a tertiary
           care center at Kanchipuram: an observational study

    • Authors: Vaishnavi Duvvuru, K. Sadagopan, M. Sneha
      Pages: 787 - 791
      Abstract: Background: Among the other systemic manifestations of COVID-19, cutaneous manifestations are also seen increasingly, but literature about those are significantly less. The skin manifestations in COVID are polymorphic according to studies. The aim of the study was to determine the cutaneous manifestations in COVID-19 positive patients at a tertiary care centre in Kanchipuram.Methods: The ethics committee approved this study in our institution. The study period was 6 months (May 2020-October 2020) and those found to be SARS‐CoV‐2 positive after testing with RT‐PCR test were enrolled.Results: In 200 patients, 20 (10%) patients had dermatological manifestations, of which urticaria was present in 7 patients (35%), pruritus was present in 4 patients (20%), 2 (10%) had urticarial vasculitis, 3 (15%) had miliaria rubra, 2 (10%) had mask induced acne and 2 (10%) had maculopapular rash. The presence of dermatological manifestations did not show any significant association between asymptomatic and symptomatic cases.Conclusions: COVID-19 positive patients asymptomatic or symptomatic with mild to moderate symptoms can have less dermatological manifestations.
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214202
      Issue No: Vol. 7, No. 6 (2021)
  • A pilot, exploratory study to demonstrate the efficacy of a novel adjuvant
           herbal liquid supplement for skin rejuvenation and anti-aging

    • Authors: C. S. Janaki, Mukta Sachdev, Ritambhara K. R.
      Pages: 792 - 799
      Abstract: Background: Aging of skin has both intrinsic and extrinsic causative factors. Impact of oral consumption of a novel multi-component herbal skin water supplement (HSWS) by Diabliss was investigated in a pilot exploratory study.Methods: A 90-day open label clinical study among 40 healthy male and female subjects aged 35-50 years, presenting with signs of aging including wrinkles and pigmentation related skin concerns. The study assessments included dermatological, instrumental and imaging evaluation to investigate the impact of the Diabliss HSWS in providing improvements in various signs of aging.Results: The Diabliss HSWS was able to show significant improvement in skin elasticity parameters by Cutometer® with improvements that ranged between 23-54% for the six elasticity parameters, skin hydration improvements as measured by Corneometer® in forehead (30%) and cheek (34%), wrinkles reduction reductions by Antera® in forehead (25%) and crows feet area (20%), texture improvements in forehead (25%) and crows feet area (20%), reduction L* value on the localized pigmentation/ spot of 6%. The subject assessments also reported improvement in the skin and general health. There were no product related AE/SAE and the product was found to be safe and well tolerated.Conclusions: In conclusion, this water based oral nutraceutical is a novel delivery system for a skin rejuvenation adjuvant therapy which is cosmetically and systemically acceptable and tolerable for patients.
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214203
      Issue No: Vol. 7, No. 6 (2021)
  • Clinico-epidemiological profile of palmoplantar dermatoses in northeast

    • Authors: Sana S., Bijayanti Devi, Mrudula S.
      Pages: 800 - 804
      Abstract: Background: Palmoplantar dermatoses are skin diseases affecting palms and soles and are commonly seen in the dermatology practice. It can cause significant discomfort to the patients, affecting their daily activities and also is a diagnostic dilemma to the physician. To determine the clinico-epidemiological profile of palmoplantar dermatoses among patients attending the outpatient department (OPD).Methods: Hospital based cross sectional study carried out from September 2018 to August 2020 in patients attending outpatient department of dermatology in Regional Institute of Medical Sciences (RIMS) Hospital, Imphal, Manipur.Results: Of the total 200 patients, nearly half were males (50.5%). Most common age group involved was 26-45 years. Itching was the most common symptom (60%). Multiple lesions with palm alone involvement accounted for higher percentage with 39.5% followed by palmoplantar involvement. Most common palmoplantar dermatosis in the study was eczema with 23% followed by psoriasis (7.5%), dermatophytosis (7%), verruca vulgaris (6.5%), and keratolysis exfoliativa (6%).Conclusions: Eczema was the most common palmoplantar disorder followed by psoriasis. Diagnosis of palmoplantar dermatoses is important at the earliest for appropriate management which helps in improving the patient’s quality of life. 
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214204
      Issue No: Vol. 7, No. 6 (2021)
  • Cutaneous manifestations in COVID-19 patients in a district COVID care

    • Authors: Prathyusha Dasari, Swetha A. Chowdary, Haritha Samanthula, Soumya Ruvva
      Pages: 805 - 810
      Abstract: Background: COVID-19, initially started as respiratory illness and evolved to involve various systems. Skin has been the least targeted organ with manifestations limited to case reports and series in a foreign scenario. Here, we tried to understand a same in an Indian scenario.Methods: This was cross-sectional study done in district COVID centre among patients with a confirmed diagnosis of COVID-19 with cutaneous manifestations for 3 months. A detailed history, complete cutaneous examination was carried out. Timing in relation to other symptoms and severity was assessed.Results: Among the 1603 patients, 39 (2.4%) had skin manifestations. Urticaria (20.5%), petechiae/purpura (17.9%), pruritis (15.4%) were the most common followed by maculo-papular rash (7.7%), manifestations secondary to drugs (7.7%), diffuse hair fall (7.7%), pseudo-chilblains (5.1%), vesicular eruptions (5.1%), infections (5.1%), cellulitis, gangrene and livedoid vasculitis. Timing of skin lesions ranged from 2 days before (10.3%) onset of COVID-19 symptoms or diagnosis to 10 days after (69.2%). Urticaria, petechiae, maculopapular rash were seen more commonly in patients with fever and respiratory symptoms. Asymptomatic cases showed urticaria, petechiae and pseudo-chilblains. Majority were in mild and moderate disease and livedoid vasculitis patient had severe disease.Conclusions: Skin manifestations in COVID-19 are relatively uncommon in Indian scenario. However, few of the manifestations give a hint of infection while some correlate with the severity of disease.
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214205
      Issue No: Vol. 7, No. 6 (2021)
  • Clinical and dermoscopic patterns of childhood alopecia areata in a
           tertiary care centre in North India

    • Authors: Pooja Bains, Simplepreet Kaur
      Pages: 811 - 815
      Abstract: Background: To describe the clinico epidemiologic profile and dermoscopic findings in children with alopecia areata (AA) and correlate the dermoscopic findings with stage and severity.Methods: The present study was performed over a period of six months, from July 2020 to December 2020 in a tertiary care hospital where 50 clinically diagnosed children ≤15 years with AA were enrolled. A thorough clinical examination followed by dermoscopy was performed. The results were tabulated and then analyzed statistically.Results: The mean age of presentation was 9.74 years. The most common site involved was scalp and the most common dermoscopic findings were yellow dots (25/50, 50%), short vellus hair (22/50, 44%), black dots (21/50, 42%), exclamation mark hair (15/50, 30%) and broken hair (11/50, 22%).Conclusions: No significant associations was found between dermoscopic findings and severity or stage of childhood alopecia areata. There was a significant correlation of alopecia areata severity with nail findings in children with alopecia areata.
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214206
      Issue No: Vol. 7, No. 6 (2021)
  • Knowledge, attitude and behavior study on HIV awareness among continuous
           rotatory residential interns and postgraduates

    • Authors: K. Manoharan, Sowmya N., N. Ashok Kumar, D. Manoharan
      Pages: 816 - 821
      Abstract: Background: Human immunodeficiency virus (HIV) that leads to Acquired immunodeficiency syndrome (AIDS) is transmitted mainly by sexual contact and exposure to infected blood. Healthcare workers (HCWs) such as Continuous rotatory residential interns (CRRIs) and postgraduates are at risk of acquiring HIV infection, primarily due to exposure to infected blood. The chances of infection depend on occupation, procedures performed, and use of preventive measures. The aim of the study was to access and compare knowledge, attitude and behavior about HIV awareness among CRRIs and Postgraduates.Methods: A cross sectional survey of 80 CRRIs and 80 postgraduates from Sree Balaji Medical College and Hospital was taken. A self-administered questionnaire was made and information regarding age, gender, knowledge about HIV, attitude and behavior towards HIV positive individual was gathered and compared between CRRIs and postgraduates. The data was compared and analyzed.Results: The results of the study revealed that postgraduates had better knowledge about routes of transmission of HIV compared to CRRIs. However, knowledge about preventive guidelines, vaccines and prophylaxis have to be improved by both postgraduates and CRRIs. Attitude towards HIV affected individual was positive. Behavior and practices followed to prevent HIV transmission have to be improved.Conclusions: HIV is an occupational hazard among HCWs. Appropriate knowledge about HIV is important. Attitude towards HIV infected individual plays an important role as it determines the care of the patient. Practicing standard guidelines while phlebotomy prevents the infection.
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214207
      Issue No: Vol. 7, No. 6 (2021)
  • Knowledge, attitude and behaviour study on urticaria patients towards
           urticaria and diet

    • Authors: Geo Celestin Danny, Suzsmi Saravanan Latha, Sane Roja Renuka, Manoharan Dhanraj, Tanjore Venkaswamy Ramesh
      Pages: 822 - 826
      Abstract: Background: Urticaria (‘hives’ or ‘nettle rash’) consists of blanchable, erythematous, edematous papules or wheals. These wheals vary in size from 1 mm to many centimetres, and are usually very itchy. They are caused by vasoactive mediators, predominantly histamine, released from mast cells. In majority of cases, the wheals are transient, lasting for only a few hours in any one place, but with new wheals appearing in other places. The aim of the study was to assess the knowledge, attitude and behaviour towards urticaria and diet among patients.Methods: A cross sectional study was done among urticarial patients visiting DVL OPD at Sree Balaji medical college and hospital using self-reported questionnaire from January to February 2021. Questionnaire was designed in manner that general population can understand and was distributed randomly irrespective of gender. Sample size of 50 was taken.Results: The results of the study revealed that most of the patient had the knowledge about urticaria and were aware about their trigger factors. Regarding behaviour most of the patients were ready to do lifestyle modifications. Regarding attitude urticarial patient had no problems mingling with the normal people.Conclusions: Urticaria is a relapsing condition with impact on quality of life. Specific elimination diets have observed high rates of response after a duration of 3 weeks. It has been confirmed that some patients experience worsening of symptoms after ingestion of foods including food additives as well as foods such as tomatoes, herbs, seafood, alcohol, and others.
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214208
      Issue No: Vol. 7, No. 6 (2021)
  • Study of the therapeutic efficacy and safety of intralesional tranexamic
           acid (25 mg/ml) for the treatment of melasma in male patients: A single
           centered “before-after” observational study

    • Authors: Yog R. Verma, Karaninder S. Mehta, Pushpinder S. Chauhan, Vikram K. Mahajan, Monika Chandel, Hitender K. Sharma, Anuj K. Sharma, Reena K. Sharma, Amit Chauhan
      Pages: 827 - 834
      Abstract: Background: Melasma is a common and difficult to treat hypermelanosis of poorly understood etiopathogenesis with great tendency to relapse. Tranexamic acid (TA) has been used in various formulations for its treatment, but there is paucity of studies/data and no consensus on the optimum dosage of intradermal TA, especially among the male patients. To study the efficacy and safety of intralesional TA 25 mg/ml for the treatment of melasma in male patients.Methods: Total 58 males were enrolled for study from July 2019 to June 2020. TA in 25 mg/ml strength injection and about 0.05 ml was injected intradermally at 1 cm apart on the entire melasma lesion, not exceeding 50 mg per visit and repeated every 4 weekly for 12 weeks. The percentage reduction in MASI was the primary outcome measure. It was determined every 4th week till 12 weeks and finally at 24 weeks for recurrence.Results: Mean MASI decreased from baseline score of 8.42±5.63 to 6.71±4.65, 5.09±3.59 and 3.41±3.06 at the follow up week 4, 8 and 12 respectively with a significant decrease from 8th week onwards. Majority of the patients were satisfied with their improvement after treatment (67.2%) without any significant adverse effects.Conclusions: However, the TA was found to effective in all the three histopathological types of melasma but the dermal melasma was least responsive as well as earliest to relapse. We recommend monthly therapy at 25 mg/ml as more efficacious, time saving and cost effective to all the three types of melasma. 
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214209
      Issue No: Vol. 7, No. 6 (2021)
  • Homologous autoimplantation; an effective modality in the treatment of
           multiple warts; a non-randomized interventional study at a tertiary care
           hospital in North-Eastern India

    • Authors: Mary Zothanpuii Chhangte, Shikha Verma, Anita Marak, Binod Kumar Thakur
      Pages: 835 - 839
      Abstract: Background: Although there are multiple treatment options, viral warts are known for their persistence and recurrence. Surgical autoimmunization is believed to work by inducing a cell-mediated immune response to clear verrucae-inducing human papillomavirus from the body.Methods: The study was conducted as a non-randomized interventional study at a Tertiary Care Hospital in North Eastern India. All patients above 18 years of age attending the Dermatology Clinic who were diagnosed as having multiple warts were included in the study. Autoinoculation was performed after taking patient’s consent and patients were followed up monthly for 3 months. Photographs were taken at each visit to have an objective comparison, and results assessed at the end of 3 months.Results: Out of 65 patients, 18 patients were lost to follow up and 47 patients completed the study. Complete resolution was found in 17 patients and 10 patients had partial resolution at the end of the study. The response was higher in those from the rural population compared to those from the urban areas and also in those with a short duration of the disease.Conclusions: Autoinoculation is an effective and safe treatment modality especially in palmoplantar warts. Early intervention is required as the response was better in patients with a short duration of the disease, which was statistically significant. Further studies should be done in other clinical variants of warts to see for significant response.
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214210
      Issue No: Vol. 7, No. 6 (2021)
  • A clinical study to assess disability and stigma associated with psoriasis

    • Authors: Ayesha Khalid, Savita Chaudhary, Kshitij Saxena, Gaurav Paliwal, Chandni Jain, Aliza zaidi
      Pages: 840 - 847
      Abstract: Background: Psoriasis relatively common, chronic, inflammatory and hyper-proliferative skin disease that affects 1.4% to 2.0 % of the population. Pateints with psoriasis have to face severe problems with stigmatization, discrimination and negative attitudes in general among the public, and often bear the brunt of public rejection.Methods: A cross-sectional observational study was carried out on psoriasis patients attending dermatology outpatient department of Era’s Lucknow medical college and hospital between November 2018 and November 2020. Patients with pustular psoriasis, mycosis fungoides, pityriasis rubra pilaris, and other severe medical conditions like heart failure, liver cirrhosis were excluded from the study.Results: Present study included 170 (aged 16 to 76 years; mean age 37.74±13.70 years; 62.4% males) clinically diagnosed patients of Psoriasis. P-score was observed with increase in Body Surface area, maximum for cases with BSA ≥25%. There was a strong positive significant linear correlation between stigmatization scores and disability scores (r=0.746; p<0.001), thus indicating that with increase in p scores there was a significant increase in PDI scores and vice versa.Conclusions: Present study showed that feeling of stigmatization and disability was highly prevalent in psoriasis patients. It was seen that stigmatization and disability showed a strong correlation. The findings of study showed that there is need to create awareness regarding psoriasis as a non-communicable disease in order to increase the acceptance of psoriasis patients in society and to reduce their stigmatization. 
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214211
      Issue No: Vol. 7, No. 6 (2021)
  • A real-world, non-interventional Indian study on clinical assessment of
           intense moisturizing formulation in dry skin disorders

    • Authors: Dhiraj S. Dhoot, Namrata Mahadkar, Hanmant Barkate
      Pages: 848 - 851
      Abstract: Introduction: Moisturizers account for the largest and important skin care product categories and are the backbone in the management of dry skin conditions associated with atopic dermatitis (AD), psoriasis and ichthyosis. Methods: A multicentre, retrospective data analysis was done at 145 dermatology clinics across India in patients who were prescribed MaxRich®. Patients with history of xerosis with an identifiable causes like atopic dermatitis, psoriasis and ichthyosis were included in study. Effectiveness data in terms of improvement in Dry Skin Area and Severity Index (DASI) Score compared to baseline and physician global assessment at the end of treatment for improvement in xerosis were captured.Results: There was significant reduction in mean DASI score as compared to baseline at week 2 & 4 (p<0.01). As compared to baseline, a significant decrease in DASI score was observed by 47.7% and 82.4% at the end of week 2 and 4 respectively. As per physician global assessment, 458 patients (83.4%) noticed very good improvement in xerosis at the end of 4 weeks whereas 82 patients (14.9%) recorded moderate improvement. Similar results were also obtained for patient global assessment where 478 patients (87%) recorded very good improvement; 67 patients (12.2%) and 6 patients (1.1%) recorded moderate and mild improvement respectively. There were no adverse events reported with MaxRich®.Conclusion: MaxRich®, an intense moisturizer was effective in improvement of DASI score associated with atopic dermatitis, psoriasis and ichthyosis and can be considered as an adjunct therapy in the management of these skin disorders for better results.
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214212
      Issue No: Vol. 7, No. 6 (2021)
  • Omalizumab for the treatment of chronic spontaneous urticaria: a
           systematic review

    • Authors: Nishitha Gopal Rao, Hai Xia Jing, Ahmed Raihan Kabir, Rohit Surthi
      Pages: 852 - 862
      Abstract: Chronic spontaneous urticaria (CSU) is a mast cell-driven skin disease characterized by the recurrence of transient wheals, angioedema or both lasting for more than 6 weeks duration. Omalizumab is a newer humanized anti IgE immunoglobulin along with many new antibody treatments has shown beneficial effect in treatment of chronic spontaneous urticaria. Although many randomized clinical trials have been conducted, as of now, the effectiveness of omalizumab in the real world management of CSU is largely unknown. A systematic review of all studies should be done. The objective was to study the efficacy and safety of different doses of omalizumab in the treatment of chronic spontaneous urticaria which was refractory to treatment with H1 antihistamines. Suitable studies were recognized after searching Wiley online library, PubMed, Google scholar, NEJM/NEJ dermatology, JAAD, JACI, Only randomized, double-blind, placebo-controlled clinical trials with omalizumab versus antihistamine or leukotriene antagonists as placebo were involved in this study. 10 randomized, placebo-controlled studies were involved with 1692 patients with CSU. Patients treated with omalizumab (75-600 mg every 4 weeks) had reduced UAS7 score, improved QoL (quality of life), reduced WISS, when compared to the placebo group. The effects of omalizumab were found to be dose dependent, with maximum reduction in UAS7 at a dose of 300 mg when given at an interval of 4 weeks’ duration. The incidences of adverse events were almost similar in both control and placebo groups and across various dose ranges. The best effect in reduction of clinical symptoms and QoL in CSU patients was found at a dose of 300 mg subcutaneous injection once a month of omalizumab for 12 to 24 weeks. Omalizumab was found to reduce the clinical symptoms and signs in patients with CSU who were symptomatic despite treatment with upscaling dose of H1 antihistamines.
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214213
      Issue No: Vol. 7, No. 6 (2021)
  • Hyperbaric oxygen therapy as an adjunctive treatment for pyoderma
           gangrenosum: a case report

    • Authors: Alan A. Katz, Kristin Thomson, Ursa Amin
      Pages: 863 - 865
      Abstract: Pyoderma gangrenosum is an uncommon inflammatory dermatosis associated with chronic wounds. Diagnosis and management can be challenging to clinicians due to the relapsing nature of the disorder, atypical presentations, and exclusion of other conditions before diagnosis. Hyperbaric oxygen therapy is not a mainstay of treatment for pyoderma gangrenosum, but it is used for non-healing wounds associated with diabetes and vascular insufficiency due to its primary mechanism of tissue hyperoxia, resultant angiogenesis, and reduction of edema and inflammation. This case report presents two patients with pyoderma gangrenosum who were provided adjunctive therapy with hyperbaric oxygen with favorable outcomes.
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214214
      Issue No: Vol. 7, No. 6 (2021)
  • Subcutaneous panniculitis-like T cell lymphoma: a rare entity and its
           cryptic journey through pregnancy

    • Authors: Surender Singh, Siddhi B. Chikhalkar, Aditi A. Shende, Vidya D. Kharkar, Prateek Oswal
      Pages: 866 - 868
      Abstract: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare form of skin lymphoma that primarily is localized to the subcutaneous adipose tissue and accounts for less than 1% of all peripheral T-cell lymphomas. It presents with multiple subcutaneous nodules or plaques on extremities and has poor prognosis if accompanied by hemophagocytic syndrome. Differential diagnosis is panniculitis, lupus panniculitis and leprosy. We report such a rare case of a female with lupus erythematosus (LE) panniculitis like presentation with favourable outcome to oral steroids in pregnancy.
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214215
      Issue No: Vol. 7, No. 6 (2021)
  • Successional occurrence of two papulosquamous disorders in HIV positive
           patient: a rare case report

    • Authors: Nitika Sanjay Deshmukh, Ravindranath Brahmadeo Chavan, Anil Prakash Gosavi, Supriya Ashok Kachare
      Pages: 869 - 871
      Abstract: Presentation of two papulosquamous disorders in a same individual is rare condition till date. Independently, psoriasis and Lichen planus (LP) are common inflammatory skin conditions affecting around 2-3% and 1% of HIV (Human immune deficiency) positive population respectively. As reviewed in the literature, psoriasis may be independently associated with other autoimmune conditions like vitiligo, alopecia areata, lichen planus, and discoid lupus erythematosus. In this article, we presented a case report of a HIV seropositive patient who suffered from psoriasis and lichen planus. The coexistence of psoriasis and lichen planus in one individual is rare and underreported in literature. Psoriasis or lichen planus may be the presenting feature of HIV infection and tends to be more severe, to have atypical presentations. Psoriasis and lichen planus can be coexistent or successionally appear one after other in one individual though rare presentation. High index of suspicion is always required while dealing with papulosquamous lesions in PLHIV. 
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214216
      Issue No: Vol. 7, No. 6 (2021)
  • Sexual abuse leading to secondary syphilis in an intellectually disabled
           person: a case report

    • Authors: Rajesh Munusamy, Nithin Nagaraja
      Pages: 872 - 875
      Abstract: Syphilis is a sexual transmitted infection (STI) caused by a spirochete, Treponema pallidum. Condylomata lata is a characteristic lesion seen in secondary syphilis. Here we reported a case of 24 year old unmarried male with intellectual disability who presented with condyloma lata over the scrotum, prepuce and perianal region and with moth eaten alopecia over scalp since 1 month. Here the patients mother revealed he had promiscuous relationship with multiple friends, which is a sexual abuse since the patient is intellectually disabled. Clinically diagnosed as secondary syphilis. Venereal disease research laboratory (VDRL) test titre was reactive at 1:32 and Treponema pallidum hemagglutination test (TPHA) was positive. Biopsy was also done, which confirmed diagnosis. Single dose of injection benzathine penicillin G, 2.4 million units was administered intramuscularly. Patient did not develop a Jarisch-herxheimer reaction. On follow up his lesions healed and VDRL titres also came down and non-reactive at 3 months. Here in this case sexual abuse lead to secondary syphilis since patient was intellectually disabled so he couldn’t address his complaints clearly. Hence counselling was done to the patient and family members by dermatologist and psychiatrist. 
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214217
      Issue No: Vol. 7, No. 6 (2021)
  • Counseling in psoriasis: overcoming the concerns and challenges

    • Authors: Kiran Godse, S. G. Parasramani, Abhishek De, Nitesh Kumar Singh, Pallavi Kawatra
      Pages: 876 - 881
      Abstract: Psoriasis is a systemic, immune-mediated disorder, characterized by systemic inflammation predominantly in skin and joints with significant physical and psychosocial consequences. It is a chronic disease with an unpredictable journey consisting of flares and remissions.  Psoriasis has also been linked to loss of self-esteem in patients, depression and suicidal tendencies. In addition, it also contributes to financial burden due to the long-term management. This results in negative impact on the caregivers and family of the patient. Due to these multiple factors, there has been low compliance to therapy and higher likelihood of discontinuation of treatment. Considering the emotional aspect involved in this disease, counseling of the patients becomes one of the integral pillars for the management of the disease. Hence, the clinician’s role becomes significant, due to limited access to counselors, therapists and social groups, in our country. The present reviewdescribes the impact of psoriasis on the patient’s life and the practical approaches that may be taken to counsel the patient of psoriasis.
      PubDate: 2021-10-27
      DOI: 10.18203/issn.2455-4529.IntJResDermatol20214218
      Issue No: Vol. 7, No. 6 (2021)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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