International Journal of Research in Dermatology

COVID-19 vaccine induced subacute cutaneous lupus erythematosus

2025-08-22T06:52:38+0530

It has been documented that COVID-19 vaccinations have been associated with the exacerbation of underlying autoimmune conditions as well as the new onset development of these disorders. In the following case, we present a 60-year-old Caucasian female with no prior documented autoimmune history who developed a blistering rash four days after receiving Moderna’s messenger ribonucleic acid vaccine. Initial laboratory and histopathology findings revealed elevated inflammatory markers and interface dermatitis. Over the course of several weeks, her rash progressed to bleeding and desquamation that covered approximately 80% body surface area. Further workup indicated positive ANA antibody and SS-A/Ro antibody leading to the diagnosis of subacute cutaneous lupus erythematosus (SCLE). She was treated with systems and topical steroids, as well as hydroxychloroquine. Six months post-diagnosis revealed marked improvement of her skin findings. Given the onset of her symptoms in relation to vaccine administration, it is suspected that Moderna’s vaccine may be associated with autoimmune disease onset.

Bone betrayal: avascular necrosis in psoriatic arthritis

2025-08-22T06:52:34+0530

Psoriatic arthritis is a multifaceted inflammatory condition with varied musculoskeletal manifestations. Although hip joint involvement remains uncommon, but may lead to severe sequelae such as avascular necrosis (AVN), especially in the presence of steroid exposure. We report the case study of a young male with history of chronic plaque psoriasis who presented with pain of lower back and right hip. There were no records of any corticosteroid exposure, trauma, alcohol consumption or any metabolic disorders. On examination, the patient was found to have enthesitis and nail changes, suggesting possibility of psoriatic arthritis. Magnetic resonance imaging revealed grade 2 AVN of the right femoral head without sacroiliitis. This case study highlights the possible occurrence of AVN in patient with psoriatic arthritis. This could be attributable to the mechanisms causing systemic inflammation and disruption of the vascular integrity. It emphasizes the need to screen for atypical manifestations in PsA so as to enable timely management.

Anacardium occidentale-induced cutaneous reaction: a rare presentation of irritant contact dermatitis

2025-08-22T06:52:33+0530

Cashew apples, obtained from the Anacardium occidentale tree, are widely used in food preparation across tropical regions like India. While raw cashew apples are generally regarded as edible, it's important to be aware that they can carry some unanticipated skin risks. This is primarily due to the presence of irritants such as anacardic acid, cardol, and cardanol that can affect the skin. These substances, chemically related to urushiol (found in poison ivy), are known to trigger irritant contact dermatitis (ICD). We present a case of a 40-year-old housewife who developed sudden-onset skin inflammation after handling raw, wet cashew apples for the first time. Within 20 minutes, she experienced intense itching, redness, swelling, and blistering on her hands and forearms. The lesions progressed to bullae with serous discharge, typical of ICD. There was no prior history of allergies or dermatological conditions. The patient responded well to systemic corticosteroids (Omnocortil), antibiotics (Roxithromycin), antihistamines, and topical mupirocin. This case highlights the need for greater public and clinical awareness about the dermatotoxic potential of cashew apple exposure in non-industrial settings. Preventive measures, such as using gloves and minimizing skin contact, are crucial when handling cashew products. Clinicians should maintain a high index of suspicion for plant-based irritants in patients presenting with acute dermatitis and a clear exposure history.

Beyond the usual: a case of acrodermatitis enteropathica clinically resembling erythrokeratoderma variabilis

2025-08-22T06:52:26+0530

Acrodermatitis enteropathica (AE) is an uncommon genetic condition marked by impaired zinc absorption, often presenting with skin and hair changes. An 18-year-old male came to our department with longstanding scaly skin lesions showing a migratory pattern, closely resembling erythrokeratoderma variabilis (EKV), along with universal hair loss. Symptoms had worsened after using traditional remedies. A family history of similar complaints in a sibling was noted. His serum zinc level measured 116 ng/ml. Treatment with oral zinc at 3 mg/kg showed limited improvement, which significantly increased after raising the dose to 5 mg/kg. Based on the periorificial involvement, alopecia, family history, and response to zinc, a diagnosis of AE was made. This case highlights an atypical presentation of AE mimicking EKV, emphasizing the need for high suspicion in unusual dermatoses and the importance of therapeutic response in guiding diagnosis.

A study of the therapeutic application of Yoga Prana Vidya healing protocols in successful facial healing

2025-08-22T06:52:25+0530

The goal of facial rejuvenation procedures is to enhance the skin's appearance by correcting spots, scars, fine lines, wrinkles, and uneven skin tone. These treatments include more intrusive operations like facelifts as well as non-invasive ones like chemical peels and laser therapy. Yoga Prana Vidya (YPV) system facial healing treatments are non-invasive, drug-free and often tailored to address particular issues and produce a range of satisfactory outcomes, from minor enhancements to more significant changes. This study presents successful facial healing cases of two young men aged 30 and 25 using YPV techniques. Multiple case study method is used by collecting data from the two clients and the YPV healer. In both cases using daily healing sessions of 30 minutes each over a period of 3 months, complete and permanent improvements were achieved to the satisfaction of the clients. During a follow up after a year and a half, the two clients reported sustained changes. YPV healing regimens have been shown to be highly beneficial in successfully healing a number of health disorders without the need for pharmaceutical or surgical treatments. Further research utilising suitable samples and methods is advised.

Bruises of the mind: unmasking Gardner-Diamond syndrome in a middle-aged woman

2025-08-22T06:52:23+0530

Psychogenic purpura, also known as Gardner-Diamond syndrome (GDS), is a rare psychocutaneous disorder characterized by the spontaneous development of painful, bruise-like skin lesions in response to emotional stress. Hereby reported is case of a middle aged-female, presenting with painful purpurae over bilateral lower limbs, with an underlying concealed history of stress. Further evaluation portrayed absence of any bleeding or clotting disorders, albeit with a positive auto erythrocyte sensitization test. Considering a diagnosis of psychogenic purpura, and after thorough psychological counselling, she depicted remarkable improvement in her skin lesions. This rare case report highlights the increased need for creating awareness amongst dermatologists about psychocutaneous diseases and emphasizes the importance of keen history taking, including an in-depth psychological evaluation. This report also underscores the role of autoerythrocyte sensitization test, making it an indispensable clinical tool in dermatological diagnosis, as every purpura does not reflect a coagulation disease or vasculitis.

A novel case study on safety and efficacy profile of intralesional vitamin D3 in the treatment of multiple cutaneous warts

2025-08-22T06:52:37+0530

Immunotherapy has now become one of the emerging therapeutic tools for treatment of multiple warts. In this case series we tried to analyse the safety and efficacy profile of intralesional vitamin D3, a novel immunotherapeutic agent. A total of 24 patients between 12 to 60 years having more than 3 cutaneous warts were included. Four patients lost follow up and 20 patients were studied. Each patient received 0.1 ml of vitamin D3 (15 mg/ml, 6L IU/ml) injected intralesionally into one wart, with a maximum of 5 warts treated. The injection is repeated 2 weeks once until complete resolution or total of 4 injections. The primary outcome measure is complete resolution of warts and return of normal skin markings. Out of 20 patients, 15 (75%) showed complete clearance. One patient showed recurrence during follow up period. Adverse effects are all minimal including erythema, induration and pain at the injection site. Injection vitamin D3 is a safer, inexpensive, easily available and effective immunotherapeutic agent for treatment of multiple warts. The injection site must be carefully selected to avoid disfiguring induration.

Trends and techniques: a statistical review of hair care product evaluation research

2025-08-22T06:52:32+0530

The growing interest in hair care products has led to an increase in clinical studies assessing their safety and efficacy. As statistical analysis plays a critical role in validating study outcomes, it is essential to evaluate the appropriateness and reporting quality of these methods. This review systematically examines the statistical techniques used in human clinical trials on hair care to assess their suitability, consistency, and transparency. A comprehensive search of the PubMed database identified 22 eligible studies published between January 2020 and April 2025, in accordance with PRISMA guidelines. Key data extracted included study design, sample size, outcome measures, and statistical methods employed. The most frequently used techniques included the Shapiro-Wilk test for normality assessment; paired and independent t-tests; Wilcoxon signed-rank and Mann-Whitney U tests for group comparisons; and Chi-square or Fisher’s exact tests for categorical data. More complex studies incorporated repeated measures ANOVA, ANCOVA, or linear mixed-effects models to manage longitudinal or multivariable data. While the majority of studies applied statistically appropriate methods, significant variation was observed in the reporting of test assumptions, effect sizes, and justification for statistical choices. Such inconsistencies may limit the reproducibility and interpretability of findings. This review highlights the need for improved standardization and transparency in the application and reporting of statistical methods in hair care research to strengthen the quality, reliability, and comparability of future clinical evidence.

From skin to mind: the psychological consequences of psoriasis severity and approaches to coping

2025-08-22T06:52:31+0530

Psoriasis is a chronic, systemic, inflammatory skin condition that causes red, scaly, and pruritic lesions. Psoriasis can be detrimental to both physical and mental health. The worsening of psoriasis is caused by mental stress, especially depression and anxiety. Approximately 34% of patients with psoriasis exhibit signs of anxiety. Symptoms of anxiety are present in about 34% of patients with psoriasis. Studies reveal that 15% of patients meet the diagnosis for social anxiety disorder, 11% for generalized anxiety disorder, and 9% for unspecified anxiety disorder. Higher rates of depression and anxiety are observed among patients with severe psoriasis compared to those with less severe psoriasis. Psychosocial distress and higher levels of anxiety and depression scores are noted in women and younger patients. The Salford psoriasis index (SPI) and dermatology quality of life index (DQL) are good measures to evaluate the severity of the disease and quality of life (QoL), respectively. Both these indices confirm an inverse relationship between the severity of psoriasis and a decrease in mental health. Psoriasis requires a multidisciplinary plan to treat both psoriasis and the associated mental health conditions. There is evidence-based data for the effectiveness of cognitive-behavioral therapy (CBT) and mindfulness-based therapies in the treatment of psoriasis patients. Having a comprehensive treatment approach to treat psoriasis and mental illness simultaneously may lead to improved patient outcomes and QoL.

Benign adnexal neoplasms of the skin: a 6-year histopathological review

2025-08-22T06:52:29+0530

Background: Tumours of the cutaneous appendages of the skin are a class of benign and malignant dermatological neoplasms, which present special morphological differentiation such as glandular, pilar or sebaceous.

Methods: A descriptive, observational, retrospective, and cross-sectional study focused on the histopathological diagnoses corresponding to benign neoplasms of the cutaneous appendages reported in the La Raza National Medical Center, México. For statistical analysis, descriptive statistics were used, with frequency distribution, percentage, mean, median.

Results: A total of 8,618 skin biopsy reports were analyzed. Of these, 222 were diagnoses of benign adnexal neoplasms. The prevalence was 2.57%. Of the total, 59.9% occurred in women and 40.1% in men. The median age was 56.9 years; in an age range from 61 to 70 years old. The most frequent anatomical location was the nose with 20.3%, followed by the lower extremities with 18.9%. Neoplasms with apocrine and eccrine differentiation were the most common, representing 55.9% of cases. Poroma was the most common subtype in our study, accounting for 19.37% of cases, followed by pilomatrixomas and trichodiscomas, both accounting for 15.77%.

Conclusions: Benign adnexal neoplasms of the skin have a prevalence of 2.57%. They occurred mostly in women aged 61 to 70 years. The most common adnexal tumor was poroma, and the most common location of appearance was the nose.

Dermatological changes in pregnant women treated in public health units

2025-08-22T06:52:38+0530

Background: Pregnancy, particularly its second and third trimesters, causes intense physical, emotional, and psychological changes in women, including the skin, hair, and nails. Objectives were to describe the association between dermatological changes and sociodemographic conditions, anthropometric nutritional status, and previous and gestational diseases.

Methods: This cross-sectional study was conducted in Brazilian public health units, including women in the third trimester of pregnancy with or without dermatological lesions. They answered a questionnaire with sociodemographic data, health history, and dermatological changes. The researchers photographed the lesions and recorded the dermatological and anthropometric assessment results on a form. They used statistical tests (e.g., ANOVA and chi-square) and Spearman's correlation, with a 5% significance level.

Results: The study analyzed 100 pregnant women with a mean age of 26.35±6.49 years and a mean income of 1.68±0.72 Brazilian minimum wages; 30 (30%) women had previous diseases, and 64 (64%) did not report obstetric history. Phototype II was the most common, in 41 (41%) women, and hyperchromia and stretch marks were the most frequent dermatoses. Pre-gestational BMI correlated significantly with the number of dermatological changes-which had a higher prevalence in obese pregnant women. Thin pregnant women had a mean of 2.75±0.95^a dermatological changes; normal-weight women, 2.50±1.34^ab; overweight, 3.16±1.34^a; and obese, 3.55±1.21^ac (p=0.014). Furthermore, 82.8% of patients with stretch marks had inadequate weight gain.

Conclusions: The study highlights the complexity of obstetric care in this population, requiring a multidisciplinary approach in prenatal care, focusing on managing metabolic and cardiovascular comorbidities, weight control, and prevention of dermatological complications.

Assessment of sunscreen usage among adults in the metropolitan area of Puerto Rico: implications for skin cancer prevention

2025-08-22T06:52:36+0530

Background: Skin cancer incidence is rising in Puerto Rico. However, there is limited data on sunscreen knowledge and behaviors. This study evaluates these factors in Puerto Rico’s metropolitan area to identify barriers to effective sun protection and address a critical gap in the literature.

Methods: A 31-question survey evaluated sunscreen behaviours, knowledge and perceptions among 205 adults in Puerto Rico's metropolitan area. Participants were recruited via QR codes and clinic referrals, with data analyzed using descriptive statistics, Chi-square and t-tests with significance set at p<0.05.

Results: While 83.41% acknowledged sunscreen’s role in preventing skin cancer, only 33.17% reported daily application. Among those who use sunscreen, 21.0% reported that they do not reapply it throughout the day. Additionally, 13.17% stated that timing of application does not matter as long as sunscreen is applied. Half of participants (50.24%) reported using an arbitrary amount instead of the recommended 1 ounce (approximately a shot-glass full) for full-body coverage. Females reported significantly higher daily use (39.74% vs. 14.81%, p=0.001) and greater concern about skin cancer all the time (40.40% vs 14.81%, p<0.0001). Younger adults had higher sunburn rates (84.62% vs. 50.88%, p<0.001) and more frequently identified the correct reapplication interval (48.35% vs. 23.68%, p<0.001).

Conclusions: The study highlights critical gaps in sunscreen use and knowledge specific to Puerto Rico, particularly among younger adults and males. Targeted education on correct sunscreen uses and the risks of inadequate protection is essential to reduce the rising incidence of skin cancer in Puerto Rico.

A questionnaire-based survey among Indian dermatologists regarding the management of androgenetic alopecia with nutritional supplements

2025-07-16T06:54:09+0530

Background: Androgenetic alopecia (AGA) is highly prevalent among Indians. Regardless of the type of alopecia, nutritional deficiency is common among Indians experiencing hair loss. However, data on clinical practices for using nutritional supplements as an adjunct in the management of AGA are lacking. The present questionnaire-based survey assessed the epidemiology of AGA, the role of nutritional supplements (their benefits and safety) and the real-world benefits (from patients’ and physicians’ perspectives) of a novel nutritional supplement containing a natural dihydrotestosterone (DHT) inhibitor, amino acids, vitamins, minerals and antioxidants as an adjunct in managing AGA.

Methods: Responses to the questionnaire were obtained from 236 healthcare professionals (HCPs) who treated 10 patients each for AGA in their routine practice and data were summarised as frequencies and percentages.

Results: More than half the HCPs opined that AGA is common among Indians aged 20–30 years. The majority of HCPs (97.46%) stated that AGA is more common in males than females. Approximately 58.47% of HCPs indicated that nutritional supplements containing DHT inhibitors are a better alternative adjunct treatment for AGA, whereas 99.15% reported that they had excellent (35.17%) or good (63.98%) efficacy. Overall, 92.36% of HCPs agreed (52.11%) or strongly agreed (40.25%) that a nutritional supplement pack lasting 15 or 30 days helps to improve compliance.

Conclusions: The survey findings indicate that the novel comprehensive nutritional supplement containing a natural DHT inhibitor is a good adjuvant in the treatment of AGA.

A clinical study of pemphigus vulgaris and its variants, evaluation of safety and efficacy of glucocorticoids versus immunosuppressants at tertiary care hospital: a study of 75 cases

2025-08-22T06:52:35+0530

Background: Pemphigus is an autoimmune blistering disorder affecting skin and mucous membranes. Autoantibodies target desmoglein proteins, leading to acantholysis. Glucocorticoids (GCs) are the primary treatment, but long-term use leads to side effects, prompting the use of other immunosuppressants like cyclophosphamide, rituximab, azathioprine, methotraxate for steroid-sparing effects.

Methods: Seventy-five pemphigus patients were included. Diagnoses were based on clinical and histopathological findings. Patients were treated with GCs alone or in combination with immunosuppressants like cyclophosphamide, rituximab, azathioprine, methotraxate. Clinical remission and adverse events recorded over an 18-month follow-up.

Results: The 46 patients were treated with GCs alone, while 19 received additional cyclophosphamide. 89.5% of patients treated with GCs and cyclophosphamide achieved remission within 4 months, compared to 73.9% with GCs alone.

Conclusions: Cyclophosphamide and other immunosuppressants enhances clinical outcomes by achieving earlier remission and reducing relapse rates in pemphigus patients compared to GCs alone. Its use as an adjunct may offer significant steroid-sparing effects.

Anti-dandruff efficacy of ayurvedic scalp leave-on treatment: a double-blinded, randomized placebo-controlled clinical study

2025-08-22T06:52:30+0530

Background: This study aimed to evaluate the efficacy and safety of ayurvedic leave on treatment product in the management of dandruff through a randomized, double-blind, placebo-controlled study.

Methods: A total of 112 subjects with clinically diagnosed moderate dandruff were randomly assigned to group A (ayurvedic leave-on treatment group) and group B (placebo group), where 110 subjects completed the study. The treatment phase was for 4 weeks, followed by a regression phase of 1 week. Subjects applied the allotted product on their scalp and massaged. It’s a leave on product so the subjects were asked not to wash off.

Results: After 4 weeks of treatment, test product group A demonstrated a significantly greater reduction in dandruff severity compared to group B (p<0.05). The adherent dandruff scores in group A showed a significant reduction of 17.56 units/41% while in group B, it was noted to be 29.4%/12.4 units. Additionally, 100% of subjects in group A reported a subjective perception improvement in symptoms of dandruff within 2 weeks when compared to group B which is only by 81%.

Conclusions: Indulekha Svetakutaja scalp leave-on treatment is a safe and highly effective solution designed to combat dandruff while simultaneously enhancing the overall health of the scalp and hair.

Serum interleukin-6 as a biomarker of disease activity and severity in chronic spontaneous urticaria: a case control study in urban south Indian population

2025-08-22T06:52:27+0530

Background: Chronic spontaneous urticaria (CSU) is a challenging dermatological condition marked by recurrent wheals lasting over six weeks without identifiable triggers. While its pathogenesis is not fully understood, emerging evidence suggests a role for pro-inflammatory cytokines, particularly interleukin-6 (IL-6), in disease activity. However, its relevance as a biomarker for disease severity remains to be clarified. To evaluate serum IL-6 levels in CSU patients and determine their correlation with disease severity, compared to healthy controls.

Methods: A case-control study was conducted in the Department of Dermatology at Raja Rajeswari Medical College and Hospital from April 2023 to September 2024. Fifty CSU patients and fifty age- and sex-matched healthy controls were enrolled. Disease severity was assessed using the Urticaria Activity Score over 7 days (UAS7). Serum IL-6 levels were measured using ELISA. All calculations were performed using Statistical Package for the Social Sciences (SPSS) version 20 (SPSS Inc., Chicago).

Results: Most CSU patients (66%) were young adults (20–40 years), with equal gender distribution. Severe disease (UAS7: 16–42) was observed in 72% of patients. Mean IL-6 levels were significantly higher in CSU patients than in controls (9.1±5.1 vs. 3.12±2.8 pg/ml, p=0.004). IL-6 levels showed a significant positive correlation with disease severity.

Conclusions: Serum IL-6 is significantly elevated in CSU patients and correlates with disease severity. It may serve as a promising biomarker for monitoring disease activity and tailoring treatment in CSU, warranting further investigation into its therapeutic potential.