International Journal of Research in Dermatology

The neutrophilic dermatitides: a contemporary reassessment of pathophysiological mechanisms, clinical phenotypes and therapeutic stratification

2026-10-24T08:43:29+0530

The neutrophilic dermatitides constitute a heterogeneous spectrum of inflammatory cutaneous disorders unified by a dominant histopathological motif of sterile neutrophilic infiltrates within the dermis, in the absence of primary infection or vasculitis. This extensive review synthesizes contemporary insights into their complex pathophysiology, which is increasingly understood as a dysregulated interplay between the innate immune system, specifically involving the interleukin-1 (IL-1) family cytokines, NLRP3 inflammasome activation, and neutrophil extracellular traps (NETs), and a permissive genetic background often influenced by somatic mutations in clonal hematopoiesis-related genes. We provide a critical analysis of the expanding clinical and histological continuum, encompassing classic entities such as Sweet’s syndrome, pyoderma gangrenosum, Behçet’s disease, and the autoinflammatory syndromes, while addressing overlapping and atypical presentations that pose significant diagnostic challenges. Furthermore, we systematically evaluate the evolving therapeutic landscape, moving beyond traditional immunosuppressants toward targeted biologic agents and small molecules that inhibit specific pro-inflammatory pathways. By integrating the latest molecular discoveries with clinical pragmatism, this review aims to refine diagnostic criteria, elucidate pathogenic connections to underlying systemic disease—particularly myeloid dyscrasias and gastrointestinal inflammation—and propose a rationale for personalized, mechanism-driven treatment algorithms. This reassessment underscores the paradigm of these conditions as cutaneous reflexes of systemic autoinflammation.

Evidence and a proposed algorithm for periprocedural treatment sequencing in melasma

2026-10-02T08:06:07+0530

Melasma treatment often combines photoprotection, topical depigmenting agents, oral tranexamic acid and procedures. Evidence for individual treatments is more developed than evidence for their order, spacing and periprocedural care. This narrative review examines the clinical literature relevant to a proposed sequence of tinted photoprotection, azelaic acid, and selected use of oral tranexamic acid, intradermal NCTF 135 HA and fractional 1064-nm picosecond laser. An existing reference collection was supplemented by targeted searches and source verification. Randomized trials support several medical components, whereas laser studies differ substantially in wavelength, optics and treatment schedules. A split-face trial found no additional clinical benefit from adding 755-nm picosecond laser to azelaic acid. Small studies of hyaluronic acid formulations use different products and delivery schedules, and do not establish the proposed pre-laser interval. We specify a candidate protocol, including a six-week medical lead-in, intradermal treatment fourteen days before laser, temporary interruption of azelaic acid and continued maintenance. The exact timing, laser settings and aftercare choices are identified as proposals for evaluation. No original patient observations or clinical outcomes are reported. The principal research questions are whether procedures add worthwhile benefit to medical treatment, whether intradermal NCTF adds further benefit, and whether any improvement persists after oral treatment stops. Controlled evaluation with standardized photographs, severity scores and complete adverse-event reporting is needed before the full sequence can be recommended as an established regimen.

The dermatologic gateway to early diagnosis of VEXAS syndrome: a comprehensive review of cutaneous manifestations and their pathognomonic significance

2026-10-24T08:43:00+0530

VEXAS syndrome (Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) is a recently recognized adult-onset autoinflammatory disorder caused by somatic mutations in the ubiquitin-activating enzyme UBA1. Since its initial description in 2020, its clinical spectrum has expanded considerably, yet diagnosis remains challenging because of its heterogeneous multisystem manifestations. Cutaneous involvement occurs in up to 90% of patients and is frequently an early or presenting feature, making dermatological findings particularly valuable for clinical suspicion and diagnosis. This narrative review summarizes current evidence on the dermatological manifestations of VEXAS syndrome, emphasizing their role as accessible markers of systemic inflammation. The cutaneous phenotype is highly heterogeneous, encompassing neutrophilic dermatoses, including sweet syndrome-like lesions, leukocytoclastic vasculitis, periorbital edema, and other inflammatory dermatoses. Histopathological findings range from dense neutrophilic infiltrates with leukocytoclasia to nonspecific perivascular inflammation. Emerging genotype-phenotype associations suggest that the p.Met41Leu variant is more frequently associated with neutrophilic dermatoses, whereas p.Met41Val may be linked to vasculitic manifestations. We also examine the evolving understanding of the genetic and clonal basis of cutaneous inflammation in VEXAS. Recognition of characteristic skin findings, particularly in older men with treatment-refractory inflammatory dermatoses, cytopenias, and systemic inflammation, should prompt consideration of VEXAS and targeted UBA1 testing. Greater dermatological awareness may facilitate earlier diagnosis, reduce diagnostic delay, and enable timely initiation of potentially life-changing therapy.

SB-NASHA: a review on scientific differentiation and skin quality enhancement

2026-10-24T08:43:20+0530

Skin aging is a multifactorial process driven by intrinsic biological changes and extrinsic environmental factors, leading to reduced hydration, collagen degradation, loss of elasticity, and the development of fine lines and wrinkles. Hyaluronic acid (HA), due to its superior hydrating, viscoelastic, and biocompatible properties, plays a central role in minimally invasive skin rejuvenation strategies. HA-based skin booster non-animal stabilized hyaluronic acid (SB-NASHA) 20 mg Skinboosters™ represent a novel therapeutic approach that improves skin quality through intradermal microinjections, restoring hydration, stimulating fibroblast activity, and promoting extracellular matrix remodelling. A structured literature review was conducted using PubMed, Scopus, Web of Science, and Google Scholar to identify studies published between 2007 and 2025 evaluating the mechanisms, clinical efficacy, and safety of SB-NASHA 20 mg hyaluronic acid skinboosters for skin rejuvenation. Eligible studies included clinical trials and observational studies reporting outcomes related to skin hydration, elasticity, texture, or patient satisfaction. Relevant data were qualitatively synthesized. Additionally, their adjunctive use with aesthetic procedures such as botulinum toxin injections or laser resurfacing has shown synergistic effects. With a favourable safety profile and minimal downtime, SB-NASHA provides healthcare professionals with an effective, evidence-based option for managing early and advanced signs of skin aging. This review offers consolidated, practice-oriented insights and expert panel perspectives to support the optimal clinical use of SB-NASHA 20 mg in aesthetic dermatology.

Statins and the skin: systematic review of dermatologic reactions to statin therapy

2026-10-24T08:43:25+0530

Statins are widely prescribed medications for lowering cholesterol levels. While generally well-tolerated, they can cause various cutaneous adverse reactions through disruption of the mevalonate pathway, affecting immune cell function and potentially triggering autoimmune responses. Aim was to systematically evaluate the clinical and histopathologic features of statin-associated cutaneous adverse reactions and review reported management strategies. A systematic review following PRISMA guidelines using PubMed, Embase, and Scopus databases was conducted analyzing cutaneous adverse reactions associated with statin therapy, including clinical presentation, histopathologic features, and management strategies. Inclusion criteria encompassed case reports, randomized controlled trials, and observational studies investigating statin-induced cutaneous adverse effects in human subjects. Studies were excluded if they were animal trials, systematic reviews, literature reviews, or did not focus on statin-related cutaneous reactions. The 22 published cases were identified, affecting patients with a mean age of 61 years (range: 44-84) and slight female predominance. The most frequently reported reactions were eczematous eruptions (6 cases), lichenoid drug eruptions (4 cases), dermatomyositis (DM) (4 cases), and pityriasis lichenoides chronica (PLC) (3 cases). Additional manifestations included lupus erythematosus tumidus (LET), pemphigus erythematosus, erythema multiforme, fixed drug eruption, and thrombocytopenic purpura. Histopathologic features commonly showed immune-mediated patterns including interface dermatitis, basal vacuolar changes, and lymphocytic infiltrates. Most cases resolved following statin discontinuation, though some required adjunctive corticosteroids or immunosuppressive therapy. This review adds to the body of literature by highlighting the breadth of statin-associated cutaneous adverse effects, emphasizing the need for clinicians to maintain a high index of suspicion when evaluating new skin eruptions in patients on statin therapy. Prompt identification and tailored management can lead to improved patient outcomes and medication safety.

Investigating the relationship between lactose intolerance and doxycycline-induced gastrointestinal disturbances

2026-10-24T08:43:24+0530

Background: Doxycycline, a highly effective broad-spectrum antibiotic, is frequently prescribed for dermatological conditions due to its anti-inflammatory and anti-bacterial properties. The adverse effects (AE) doxycycline-induced gastrointestinal (GI) are well described in the literature and clinical practice. However, the use of lactose as an excipient in doxycycline formulations is not commonly known and may contribute to symptoms in patients with lactose intolerance.

Methods: We conducted a retrospective, phone-based survey of patients with documented doxycycline use. Participants reported lactose intolerance status and GI symptoms experienced during therapy. The association was assessed using odds ratios (OR) with 95% confidence intervals (CI) and statistical significance testing.

Results: Out of 98 participants, 46% experienced GI AE. We observed that individuals with lactose intolerance are 1.979 times more likely to experience any GI AE than those without (95% CI 0.598-6.547) with a p=0.257. With a threshold of p<0.05, we could not appreciate a statistically significant association between lactose intolerance and GI AE.

Conclusions: Although lactose intolerance was associated with increased odds of GI AE, the relationship was not statistically significant. However, findings noted in this study suggest a possible trend that warrants further investigation. Larger, prospective studies are needed to confirm our observation and clarify the clinical impact of lactose-containing doxycycline formulations.

Incidence of HIV among herpes zoster patients in Khartoum Dermatology and Venereal Diseases Teaching Hospital from April 2018 to April 2019

2026-10-08T06:56:38+0530

Background: Herpes zoster (HZ) results from reactivation of latent varicella-zoster virus and is associated with ageing and impaired cell-mediated immunity, including HIV infection. Aim was to estimate the proportion of HIV-positive patients among Sudanese adults presenting with HZ.

Methods: A prospective, hospital-based cross-sectional study was conducted at Khartoum Dermatology and Venereal Disease Teaching Hospital from April 2018 to April 2019. Sixty adults with clinically diagnosed HZ were enrolled and screened for HIV using rapid diagnostic kits. Demographic and clinical information was collected using a structured questionnaire.

Results: The participants had a mean age of 37.1±9.9 years; 29 (48.3%) were male and 31 (51.7%) were female. Thirty-one participants (51.7%) were aged 25-45 years. The trunk was the most frequent rash site, occurring in 35 participants (58.3%). Twenty-five (41.7%) reported headache and/or fever during the prodromal period. All 60 participants tested negative for HIV. Prodromal symptoms were significantly associated with rash distribution (p<0.001).

Conclusions: No HIV infection was detected in this sample of patients with HZ. The result should be interpreted cautiously because of the small sample size and single-centre design. Larger studies from several Sudanese regions are needed.

Clinico-epidemiological profile of pityriasis versicolor among Sudanese patients attending Khartoum dermatology and STI teaching hospital

2026-10-06T09:26:42+0530

Background: Pityriasis versicolor (PV) is a mild, chronic, superficial fungal infection of the stratum corneum caused by Malassezia species. The condition is common in tropical climates and frequently affects adolescents and young adults. This study aimed to assess the clinical and epidemiological characteristics of PV among Sudanese patients attending a tertiary dermatology hospital.

Methods: A descriptive cross-sectional hospital-based study was conducted at Khartoum Dermatology and STI Teaching Hospital over three months (May to July 2020), including 179 Sudanese patients clinically diagnosed with PV and confirmed by potassium hydroxide (KOH) microscopy. Data on demographics, disease characteristics, clinical features, and associated conditions were collected using a structured questionnaire and analyzed using SPSS version 11.5, with chi-square test for statistical significance at p<0.05.

Results: Young adults aged 20-24 years constituted the largest affected group (32%), with a marked male predominance (73.1%; male-to-female ratio 3:1). Hypopigmented lesions (50%) and patches (68.7%) were the most common clinical patterns, and the back (67.6%), neck (52%), and upper limbs (42%) were the most frequently involved sites. Acne vulgaris (13.5%) and scalp dandruff (3.4%) were the most common dermatological comorbidities. KOH positivity was 86%.

Conclusions: The clinico-epidemiological pattern of PV in Sudan aligns with global findings, with notable variations in age distribution and ethnic prevalence. This study provides updated epidemiological data on PV in the Sudanese population after several decades, contributing to a better understanding of the disease profile in this region.

Efficacy of hybrid sun protection gel in improving skin biophysical parameters: a short term clinical study

2026-10-24T08:43:22+0530

Background: Skin is the largest organ of the human body and protects the internal organs. Skin takes the impact of multiple environmental factors, especially ultraviolet radiation from sun and is subjected to damage, manifesting as pigmentation, dryness, wrinkles etc., compromising over all skin health. Personal care industry offers sunscreens with different levels of sun protection factors (SPF) in different formats. Sun care market is rapidly growing, however there are some unmet needs of consumers like sticky/ tacky or oily feel from sunscreens preventing the usage on skin for longer duration or usage in humid weathers. The present clinical study is designed to evaluate the efficacy of test product (sun protection gel) for sun protection, with consumer acceptable sensory and other skin benefits like hydration, brightness, glow and smoothness in Indian female volunteers suffering from dull skin.

Methods: SPF study was conducted in healthy humans as per Indian BIS guidelines to establish sun protection factor. Skin benefit studies were conducted in healthy female volunteers with dull skin to assess improvement in various skin biophysical parameters, visual assessments by dermatologist and feedback from study participants on efficacy and sensory.

Results: Test product demonstrated, SPF 50 and improvement in skin brightness, glow, hydration and smoothness immediately after application of product which lasted up to 24 hours above the baseline levels.

Conclusions: The present sun care leave-on test product demonstrated an SPF 50 along with improved visual and biophysical parameters of skin, with no undesirable sensory on skin and side effects.

Efficacy and tolerability of a multi-ingredient nutraceutical on facial skin ageing parameters and self-reported wellbeing: a prospective, open-label and single-arm pilot study

2026-10-09T06:56:23+0530

Background: Skin ageing involves interconnected changes in extracellular matrix integrity, hydration, oxidative stress and cellular resilience. This study evaluated the efficacy and tolerability of RESET by IQ HEALTH™, a multi-ingredient oral nutraceutical, in adults with visible facial skin ageing.

Methods: This prospective, open-label, single-arm clinical study enrolled healthy adults aged 35-55 years with facial skin ageing. Participants consumed one sachet daily for 60 days. Facial firmness (Cutometer R0), elasticity (Cutometer R7), and hydration [MoistureMeter SC (MMSC)] were assessed at baseline, day 30, and day 60. Participant-reported skin and wellness outcomes and tolerability were assessed descriptively.

Results: Thirty-four participants-initiated supplementation and 33 completed the study. At day 60, firmness improved by 38.9%, elasticity by 8.9%, and hydration by 19.2% from baseline (all p<0.001). Significant changes were observed at day 30. At day 60, 84.9% reported firmer/tighter facial skin, 81.8% reported a younger appearance, and 90.9% reported improved moisturization and hydration. Exploratory improvements were also reported in energy, joint comfort, sleep quality, fatigue, relaxation, and muscle soreness. The product was generally well tolerated; gastrointestinal symptoms were mild and infrequent, with no serious adverse events or treatment-related discontinuations.

Conclusions: Daily supplementation with RESET by IQ HEALTH™ for 60 days was associated with improvements in facial skin firmness, elasticity, and hydration, together with favourable participant-reported skin and wellness outcomes. These findings are preliminary given the single-arm, open-label design and small sample size and require confirmation in randomized, placebo-controlled studies.

Efficacy and safety of MemBio™ intense moisturizer: barrier repair beyond hydration

2026-10-02T08:06:07+0530

Background: Dry skin is characterized by epidermal barrier dysfunction and depletion of stratum corneum lipids, leading to decreased hydration and increased transepidermal water loss (TEWL). MemBio^TM Intense Moisturizer (test product) was evaluated for clinical efficacy and safety in dry to severely dry skin.

Methods: This single-center, open-label moisture-kinetic study enrolled 26 healthy adults with dry to severely dry skin. The test product was applied to a designated forearm site while the contralateral forearm served as untreated control. Efficacy assessment included skin hydration (corneometer), skin barrier function (TEWAmeter), restore skin barrier damage, skin glow (Glossymeter), skin surface characteristics (skin smoothness, dryness, roughness, scaliness wrinkles), Desquamation Index and skin and facial photographic imaging. Measurements were performed at baseline and post application of the test product at 20 minutes on Day 1, 2, 7 and 15. Subjective perceptions of product performance and tolerability, as well as safety evaluations were recorded throughout the study period.

Results: The test product produced instant hydration within 20 minutes, maintained hydration for 24 hours, and demonstrated sustained efficacy through Day 15. Hydration increased by 129.25% at right cheek and 136.02% at tape-stripped site, while skin barrier function improved by 23.87% and 21.44%, respectively (p<0.0001). Significant improvements were also observed in skin surface characteristic (smoothness, dryness, roughness, scaliness wrinkles), desquamation index, and skin shine. No adverse events were observed during the study

Conclusions: MemBio^TM Intense Moisturizer significantly improved hydration, skin surface characteristics and restored epidermal barrier function, supporting its use as an effective daily moisturizer for dry to severely dry skin.

Comparative assessment of cutaneous delivery of clobetasol propionate from two topical cream formulations using an in vitro Franz diffusion model

2026-10-24T08:42:55+0530

Background: The therapeutic effectiveness of topical corticosteroids depends on their ability to achieve adequate skin retention while minimizing systemic absorption. This study compared the cutaneous delivery characteristics of two clobetasol propionate 0.05% cream formulations, clobetasol 0.05% cream and clobetasol 0.05% cream (innovator), using an in vitro Franz diffusion model.

Methods: Comparative skin permeation studies were conducted using excised swine skin mounted on Franz diffusion cells in accordance with OECD Test Guideline 428. A 100 mg dose of each formulation was applied to the skin surface and receptor fluid samples were collected over 12 hours. Clobetasol propionate concentrations were quantified using a validated HPLC method. Drug permeation, skin retention and surface residue were determined.

Results: Both formulations exhibited low transdermal permeation and substantial skin retention. At 12 hours, cumulative permeation was 2.52% for clobetasol 0.05% cream and 2.85% for clobetasol 0.05% cream (innovator). Skin retention was 59.25% and 52.67%, respectively, while the remaining drug was estimated as surface residue. Although minor differences in permeation kinetics were observed, the overall distribution profiles of clobetasol propionate were comparable between the two formulations.

Conclusions: Clobetasol 0.05% cream and clobetasol 0.05% cream (innovator) demonstrated comparable cutaneous delivery characteristics, with high skin retention and minimal transdermal permeation. The findings indicate that both formulations effectively localize clobetasol propionate within the skin, supporting their suitability for topical treatment of inflammatory dermatoses.

Independent predictors of hair loss among medical students: a cross-sectional study using the sinclair hair shedding scale in a tertiary medical college in South India

2026-10-24T08:43:15+0530

Background: Medical students are highly vulnerable to psychological distress due to demanding academic schedules, which can disrupt hair follicle homeostasis. This study aimed to determine the prevalence of hair loss among female medical students and identify its associated factors.

Methods: A cross-sectional study was conducted among female MBBS students at a tertiary care medical college in Kerala. Data were collected through face-to-face interviews using a pretested semi-structured questionnaire incorporating the Sinclair Hair Shedding Scale to assess hair loss and the Depression Anxiety Stress Scale-21 (DASS-21) to evaluate psychological distress. Multivariable logistic regression was performed to identify independent predictors of excessive hair shedding.

Results: The prevalence of excessive hair shedding was 22.0%. Multivariable logistic regression identified severe to extremely severe stress as the strongest predictor of hair loss (AOR=4.06; 95% CI: 1.79-9.19). Other significant predictors included a positive family history of hair loss (AOR=3.69), being a final-year MBBS student (AOR=3.08), sleeping less than 6 hours per day (AOR=2.57), severe to extremely severe depression (AOR=2.74), severe to extremely severe anxiety (AOR=2.11) and hair care practices.

Conclusions: Excessive hair shedding is a prevalent and multifactorial condition among female medical students, influenced by a combination of psychological, genetic, lifestyle, and hair care factors. Medical colleges should incorporate regular mental health screening, sleep hygiene education, and awareness of appropriate hair care to reduce the risk of excessive hair shedding.

Clinico pathological correlation of inflammatory palmoplantar dermatoses in a tertiary care hospital

2026-10-24T08:43:08+0530

Background: Inflammatory palmoplantar dermatoses (PPD), including palmoplantar psoriasis, palmoplantar pustulosis, palmoplantar eczema, palmoplantar lichen planus, lichen nitidus often mimics each other, posing a diagnostic challenge. This study was done in an attempt to identify the clinicopathological correlation of these conditions as they have an impact on the patient's quality of life. To arrive at the degree of concordance between clinical and histopathological diagnosis of inflammatory PPD.

Methods: A 15-month study (February 2018–April 2019) was done in the Department of Dermatology, Mahatma Gandhi Medical College and Research Institute, Pondicherry. Forty patients with clinically doubtful inflammatory PPD or responding poorly to treatment underwent clinical examination and lesional skin biopsy. Clinical and histopathological diagnoses were correlated.

Results: The mean age in 40 patients was 50.60 (SD=16.46) years. Psoriasis was the most common diagnosis clinically (22, 55%) and histopathologically (23, 57.5%), followed by eczema (10, 25% and 9, 22.5%) respectively. clinicopathological concordance was observed in 18 (82%) patients with psoriasis, 6 (60%) eczema, 1 (16.7%) lichen planus and 1 (100%) patient with pustulosis. It was statistically significant in psoriasis (p=0.035), eczema (p=0.03) and pustulosis (p<0.0001), but not for lichen planus and lichen nitidus. In the non-concordant group, histopathology showed nonspecific dermatitis in 6 (15%) patients.

Conclusions: Although skin biopsy did not offer a specific diagnosis in the non-concordant group, it contributed in establishing the diagnosis in the concordant group. Hence, clinicopathological correlation is valuable for establishing an accurate diagnosis and guiding appropriate treatment.

Influence of repeated cleansing on skin biophysical parameters: a randomized and double-blinded comparative study of a grade 1 toilet soap and a face cleanser

2026-10-24T08:43:11+0530

Background: The most commonly adopted face-cleansing habit is twice a day, which is part of the skin care routine. In India, face cleansing is commonly performed using soap bars, with different total fatty matter (TFM) percentages, while facial cleansers typically formulated with milder cleansing systems, such as synthetic surfactants or combinations of soap with synthetic surfactants, are also widely used. While face cleansing products may not cause skin damage, repeated washing may compromise skin health depending on cleansing characteristics of the formulation/product.

Methods: The present clinical study was a randomized, double-blinded, monocentric, split-face design, conducted in 36 healthy female volunteers aged 20–45 years. The study aimed to assess the impact of test face cleanser and Grade 1 soap upon multiple wash frequencies on various biophysical characteristics of skin.

Results: Present test face cleanser developed with fatty acid-based cleansing technology along with niacinamide, 12-HSA and glycerol demonstrated significantly superior glow, hydration and barrier integrity compared to the marketed grade 1 soap (high TFM soap) when used multiple times on the skin.

Conclusions: The present clinical study demonstrates the sustained efficacy of the test face cleanser in improving hydration, brightness and glow without compromising the skin barrier upon multiple uses, whereas the marketed high TFM soap weakened the barrier and worsened skin dullness upon multiple uses. Hence, the incorporation of skin care technologies in face cleansers to support skin hydration and barrier health can be beneficial in improving overall skin biophysical parameters, even when used multiple times.

Efficacy and safety of a ceramide-based moisturizer for xerosis and chronic kidney disease associated pruritus in maintenance hemodialysis: a randomized controlled trial

2026-10-24T08:43:06+0530

Background: Xerosis and chronic kidney disease-associated pruritus (CKD-aP) impair sleep and quality of life in patients receiving maintenance hemodialysis. Evidence for ceramide-based moisturizers in this population is limited.

Methods: This prospective, single-center, parallel-group randomized controlled trial assigned 130 adults receiving maintenance hemodialysis to a ceramide-based moisturizer applied twice daily for 8 weeks (n=65) or standard skin-care advice alone (n=65). Co-primary outcomes were changes from baseline to week 8 in Overall Dry Skin (ODS) and pruritus Visual Analog Scale (VAS) scores. Secondary outcomes included Dermatology Life Quality Index (DLQI), sleep disturbance, adherence, satisfaction, and adverse events.

Results: All participants completed follow-up. ODS scores decreased from 3.2±0.8 to 1.4±0.6 in the ceramide group and from 3.2±0.8 to 2.4±0.7 in controls (group-by-time interaction, p<0.001). VAS scores decreased from 7.1±1.3 to 2.3±1.2 and from 7.0±1.4 to 5.1±1.5, respectively (p<0.001). DLQI scores decreased from 12.1±3.4 to 4.8±2.1 and from 11.8±3.2 to 8.9±2.9, respectively (p<0.001). Sleep disturbance and satisfaction also favored the ceramide group. No serious treatment-related adverse events occurred.

Conclusions: A ceramide-based moisturizer improved xerosis, CKD-aP, dermatology-related quality of life, and sleep disturbance compared with standard skin-care advice alone. Active-comparator trials are needed to determine whether the benefit is specific to ceramides or reflects moisturization generally.

Efficacy and safety of topical 1% bakuchiol oil in adults with photoaging, hyperpigmentation, acne, skin scaling and stinging: a randomized, double-blind and vehicle-controlled clinical study

2026-10-24T08:42:48+0530

Background: Photoaging, hyperpigmentation and acne are common facial skin concerns for which effective and well-tolerated botanical alternatives are needed. This study evaluated the efficacy and safety of topical 1% bakuchiol oil in adults with mild-to-moderate facial skin concerns.

Methods: In this prospective, randomized, double-blind, vehicle-controlled, parallel-group study, 40 adults aged 25–55 years were randomized (1:1) to receive topical 1% bakuchiol oil or vehicle oil twice daily for 12 weeks. Clinical assessments and standardized facial photography were performed at baseline and weeks 4, 8 and 12. Primary endpoints were changes in photoaging and hyperpigmentation scores. Secondary endpoints included acne severity, total acne lesion count, skin scaling and stinging, skin hydration, trans epidermal water loss, subject satisfaction, tolerability and safety.

Results: All participants completed the study. Compared with vehicle, topical 1% bakuchiol oil significantly reduced photoaging (20.9%; p<0.001) and hyperpigmentation (44.8%; p<0.001) scores at week 12. Significant improvements were also observed in acne severity, acne lesion count, skin scaling and stinging, skin hydration and trans epidermal water loss (p<0.05 for all). Clinical photographs supported the quantitative findings. The treatment was well tolerated, with no adverse events reported in the bakuchiol group, compared with three mild, transient adverse events in the vehicle group.

Conclusions: Topical 1% bakuchiol oil improved photoaging, hyperpigmentation, acne-related parameters and skin barrier-related measures over 12 weeks and was well tolerated, supporting its potential as a botanical option for photoaged and acne-prone skin.

Efficacy evaluation of a topical formulation containing green tea and willow bark extract for acne and post-acne mark reduction in Indian subjects: a double-blind clinical study

2026-10-24T08:42:46+0530

Background: Consumers with acne-prone skin often experience recurring pimples, inflammation, uneven texture and stubborn post-acne dark marks linked to post-inflammatory hyperpigmentation (PIH). These concerns affect skin clarity and even tone, highlighting the need for gentle, effective topical solutions. This clinical study evaluates the efficacy of a topical formulation containing green tea extract actives (5%) and willow bark extract (2%) in reducing acne and acne marks over a 7-day period.

Methods: A double-blind, non-comparative clinical study was conducted on 36 Indian subjects (18 males, 18 females; aged 18–35 years) with mild-to-moderate acne and oily to combination skin. The test product was applied twice daily for 7 days. Efficacy was assessed using the Michaelsson acne severity index, lesion analysis, mexametry for PIH and subject self-evaluation. Safety was evaluated through dermatological assessment of irritation parameters. Measurements were recorded at baseline, day 1, day 3 and day 7.

Results: The test product demonstrated a time-dependent reduction in melanin index associated with acne-induced PIH, with mean reductions of 0.11%, 0.50% and 0.77% at day 1, day 3 and day 7, respectively. By Day 7, improvement in PIH-related acne marks was observed in up to 100% of subjects. Acne severity significantly reduced (-25.72%, p<0.001) by day 7, with notable decreases in papule and pustule redness and size and in comedones size. No adverse events or irritation were reported and 100% of subjects agreed the product reduced acne and acne marks.

Conclusions: The formulation effectively reduced acne, PIH-related acne marks and melanin index within 7 days, with good tolerability and no reported irritation or adverse events.

In vitro comparative evaluation of skin permeation and dermal retention of clobetasol 0.05% and salicylic acid 6% nano lotion and clobetasol 0.05% and salicylic acid 6% conventional lotion using excised swine skin and Franz diffusion cells

2026-10-24T08:42:54+0530

Background: Topical formulations aim to deliver drugs locally while minimizing systemic exposure. This study compared the in vitro skin permeation and dermal retention of Clobetasol Propionate 0.05% and Salicylic Acid 6% Nano Lotion with a Conventional Lotion.

Methods: Excised full-thickness dorsal swine skin was mounted on Franz diffusion cells with a diffusion area of 1.36 cm². A 100 mg dose of each formulation was applied and receptor-fluid samples were collected over 12 hours. Both active ingredients were quantified using reverse-phase high-performance liquid chromatography (RP-HPLC) with UV detection. Permeation, surface residue and skin retention were assessed using mass-balance calculations.

Results: Salicylic Acid showed time-dependent permeation from both formulations. At 12 hours, cumulative permeation was 0.969 mg (16.16%) for the nano lotion and 0.270 mg (4.50%) for the conventional lotion, indicating approximately 3.6-fold greater permeation with the nano lotion. Skin retention was 83.08% and 71.81%, respectively, while surface residues were 0.763% and 23.68%. Clobetasol propionate remained below the receptor-phase detection limit for both formulations. However, skin retention was higher with the nano lotion (86%) than with the conventional lotion (50%).

Conclusions: The nano lotion demonstrated greater salicylic acid permeation, higher dermal retention of both active ingredients and lower surface residue than the conventional lotion. These findings suggest improved dermal delivery and skin localization under the tested in vitro conditions. Further studies are needed to confirm these findings and establish their clinical relevance.

Efficacy of skin care regime in improving biophysical parameters of skin: a split face clinical study

2026-10-24T08:43:17+0530

Background: Background: Healthy and glowing skin is an aspired skin benefit among consumers and is linked to well-groomed appearance and self-esteem. Face cleansing is the first line of grooming practice as a part of hygiene among consumers. While these facial cleansers help to keep skin clean, skin also needs additional care as it is exposed to environmental pollution or solar radiation or other aggressors like dry or cold weather that can damage or strip of skin’s moisture, making it dry, rough and dull impacting the overall skin health.

Methods: The present clinical study is a randomized, mono centric, split face trial conducted in 40 healthy Indian female volunteers in the age group of 20-45 years. The objective of the study was to evaluate the efficacy of a face cleanser vs regime (face cleanser + face moisturiser) formulated with glycerol, niacinamide, 12-hydroxystearic acid and hexylresorcinol in improving skin hydration, brightness, glow and reducing the severity of dark spots.

Results: Both regime and face cleanser demonstrated improvement in glow, hydration and reduction in dark spot intensity on 2 weeks of regular use. Regime is significantly superior in all the biophysical parameters of skin. Both cleanser and regime are well accepted among the subjects without any adverse events like redness, itching or irritation.

Conclusions: While both face cleanser and regime demonstrated improvement in skin biophysical parameters, regime was significantly superior and accepted by participants for sustained skin benefits. Hence, it is recommended to adopt regime-based skin care treatments for sustained skin benefits.

Clinical spectrum of cutaneous adverse drug reactions in the peri procedural period: a case series

2026-09-17T07:04:00+0530

Cutaneous adverse drug reactions (CADRs) are among the frequent adverse effects of medications prescribed during the postoperative period. Their diverse clinical presentations often pose diagnostic challenges, particularly when eruptions develop after completion of short-course of therapy following surgical and medical interventions. A prospective observational case series of patients presenting with suspected CADR over a 6-month period was conducted. Clinical characteristics, suspected medications, morphology, latency, treatment, and outcomes were assessed. Seventeen patients were identified, with the onset of skin lesions ranging from post intervention day 2 to day 12. The majority of patients (11/17, 64.7%) developed cutaneous eruptions between 5 and 10 days after drug exposure. Maculopapular exanthem was the predominant presentation, observed in 13 patients (76.5%), including one case with accompanying pustules. An acneiform eruption and erythematous macules were observed in one patient each (5.9%), while erythematous papules were observed in 2 (11.8%) patients. Photoexposed areas were involved in 8 patients (47.1%). Most patients had received short course of postoperative antibiotics and/or NSAIDs before the onset of the eruption. Appropriate dermatological management resulted in complete recovery in most of the patients. Delayed perioperative CADRs were most commonly manifested as maculopapular exanthems in our series, although a spectrum of atypical morphologies were also observed. Recognition of these varied clinicomorphological presentations especially after completion of postoperative antimicrobial therapy may facilitate timely diagnosis and appropriate management.

Beyond millijoules: a six-dimensional tissue-dose model for fractional ablative carbon dioxide laser therapy

2026-09-03T06:42:07+0530

Fractional ablative carbon dioxide (CO₂) laser treatment is commonly documented with displayed parameters such as pulse energy, power, pulse duration, density level and number of passes. These settings are device-specific inputs, not a portable description of the tissue dose. This perspective proposes a six-dimensional tissue-dose model that represents treatment as a state vector comprising ablation geometry, coagulation geometry, treated fraction, spatial distribution, heat accumulation and healing reserve. The framework was developed through a targeted narrative synthesis of foundational fractional photothermolysis studies, histologic and computational dosimetry work, wound-healing investigations, clinical consensus statements and complication literature. A targeted PubMed, Crossref, journal-archive and web search through 19 August 2026 did not identify a previously published framework integrating the same six dimensions. The model separates the delivered tissue insult from device settings and treats healing reserve as a biological and anatomical constraint on the acceptable exposure. It explains why equal millijoules, equal nominal density or equal total energy can produce different lesion geometry, local overlap, thermal burden and recovery. The framework is intended for treatment planning, cross-platform reporting, education and prospective data collection; it is not a validated dose calculator and does not support universal presets. Validation should combine expert content assessment, platform-specific histology or optical imaging, a common clinical data dictionary and prospective prediction of efficacy, delayed healing, postinflammatory hyperpigmentation and scarring. A shared six-dimensional vocabulary may improve reproducibility while preserving the site-and patient-specific judgment required for safe fractional ablative laser therapy.

Dermoscopic features of pediatric epidermodysplasia verruciformis in dark skin: a case report with clinicopathological correlation

2026-10-24T08:42:57+0530

Epidermodysplasia verruciformis (EV) is a rare inherited genodermatosis associated with increased susceptibility to β-human papillomaviruses and an increased risk of cutaneous malignancy. We report the case of an 8-year-old child with Fitzpatrick skin phototype VI presenting with multiple hypopigmented verrucous lesions involving the face and upper trunk. Dermoscopy revealed well-demarcated structureless hypopigmented areas, fine white scales, and peripheral leukotrichic vellus hairs. Histopathological examination confirmed the diagnosis. The patient showed marked clinical improvement following topical adapalene. This case expands the limited literature on the dermoscopic features of EV in dark skin and highlights the diagnostic value of dermoscopy as a non-invasive tool in pediatric patients.

Cutaneous leishmaniasis in a child from Dolpa, Nepal: a case report

2026-10-24T08:43:26+0530

Cutaneous leishmaniasis (CL) is a neglected tropical disease (NTD) that is endemic in South Asia. It presents as chronic ulcers. Complications of the disease might be due to the difficulty in diagnosing CL, because of the presence of lesions similar to those of other skin disorders, and the lack of diagnostic resources. A four-year-old boy from Dolpa, Nepal presented to our center with a history of 10 months of painless ulcerative lesion on his right cheek. Initially the lesion was small papule which gradually enlarged over time for which topical steroid antibiotics combination was initiated. No improvement was noted on the lesion and the lesion further ulcerate. After four months, numerous Leishmania donovani bodies was revealed by fine-needle aspiration cytology (FNAC). At our center, a well-defined, round-to-oval erythematous plaque with serous exudate and yellowish-brown crust was noted on examination. The lesion was irregular with sharply demarcated margin and surrounded by erythema. The patient was then referred to Sukraraj Tropical and Infectious Disease Hospital for further anti-leishmanial therapy according to national protocol. Baseline investigations were normal. This case highlights the challenges for diagnosis of skin NTDs like CL in rural settings and essence of keeping a high index of suspicion, early FNAC/biopsy for non-healing ulcers and access to specialized care.

Atypical necrobiosis lipoidica presenting outside the pretibial region

2026-10-24T08:43:01+0530

Necrobiosis lipoidica (NL) is a rare chronic granulomatous dermatosis classically associated with diabetes mellitus and typically affecting the pretibial surfaces. Extrapretibial involvement, particularly on the forearm, is uncommon and may create diagnostic difficulty because lesions outside the lower legs can lack the classic clinical distribution of NL. We report a 24-year-old woman with poorly controlled type 1 diabetes mellitus who presented with a slowly enlarging, occasionally pruritic plaque on the left dorsal forearm for approximately 10 years. Skin examination revealed a solitary well-defined atrophic shiny telangiectatic plaque with a central yellow hue and peripheral erythema over the extensor surface of the left forearm. Histopathological examination demonstrated necrobiotic granuloma with foci of dermal necrobiosis surrounded by lymphohistiocytic infiltrate and scattered plasma cells, confirming the diagnosis of necrobiosis lipoidica. The patient was treated with intralesional corticosteroid injections, with further therapy planned according to clinical response.Necrobiosis lipoidica can rarely present at extratibial sites, including the dorsal forearm. Recognition of this atypical presentation is important, as clinical diagnosis may be delayed when lesions occur outside the classic pretibial location. Skin biopsy remains essential for confirming the diagnosis and guiding appropriate management.

From blisters to nodules: clinical clues to epidermolysis bullosa pruriginosa

2026-10-24T08:43:31+0530

Epidermolysis bullosa pruriginosa (EBP) is an uncommon variant of dystrophic epidermolysis bullosa characterised by severe pruritus, prurigo-like nodules, milia, nail dystrophy, and scarring. Delayed diagnosis is common because blistering may become inconspicuous with age. The case report demonstrates a 44-year-old woman with a 10–12-year history of intensely pruritic papules and nodules involving the scalp, trunk, and extremities. Detailed history revealed recurrent trauma-induced blistering since childhood, delayed wound healing, recurrent great toenail shedding, and similar illness in her sister. Examination showed multiple excoriated hyperpigmented papules and nodules, milia, atrophic scarring, and dystrophic toenails. Dermoscopy demonstrated milia-like white clods and scar-like white areas, while histopathology showed acanthosis, compact hyperkeratosis, papillary dermal fibroplasia, and infundibular cyst formation. Clinicopathological correlation established the diagnosis of epidermolysis bullosa pruriginosa. Recognition of childhood blistering, nail dystrophy, milia, scarring, and family history is essential for timely diagnosis and appropriate management.

Beyond extensor surfaces: disseminated keratosis pilaris in childhood and its successful management with isotretinoin

2026-10-24T08:42:51+0530

Keratosis pilaris (KP) is a common follicular keratinisation disorder typically limited to extensor surfaces. Disseminated involvement is rare. An 11-year-old girl presented with generalised hyperpigmented follicular keratotic papules involving the face, trunk, and extremities, sparing the palms and soles, associated with mild pruritus. There was no history of atopy, systemic illness, or nutritional deficiency. Histopathology showed orthokeratotic hyperkeratosis with follicular plugging and mild perifollicular inflammation, confirming KP. Dermoscopy revealed keratin plugs with coiled vellus hairs. Laboratory investigations, including serum retinol, were normal. The patient was treated with low-dose oral isotretinoin and topical keratolytics, resulting in marked clinical improvement within six weeks. Disseminated KP is an uncommon presentation, especially in children. Recognition of atypical hyperpigmented variants is important to avoid misdiagnosis. Systemic retinoids may be effective in extensive disease.