International Journal of Research in Dermatology

A case series of comorbidities seen in bullous pemphigoid

2025-01-04T19:20:00+0530

Bullous pemphigoid (BP) is an autoimmune skin blistering disease commonly seen in the elderly which is associated with increased morbidity. The association of BP with comorbidities, especially cardiovascular, neurological, type 2 diabetes mellitus (T2DM) and has been seeing a rising trend in the recent years, not only with the underlying condition but also the drugs associated. A systematic literature review was conducted to identify and analyze the comorbidities prevalent in patients with BP.

Is this glove and boot protective: unraveling the mystery?

2025-01-04T19:19:57+0530

Pellagroid dermatitis, a rare manifestation of niacin deficiency exacerbated by chronic alcoholism, presents with distinct cutaneous and systemic symptoms. We report a case of a 42-year-old male with a history of daily alcohol consumption and heavy smoking, presenting with characteristic skin lesions predominantly over sun-exposed areas. The patient exhibited a spectrum of symptoms including dermatological manifestations, gastrointestinal disturbances, and neuropsychiatric symptoms. Diagnostic workup revealed hypoalbuminemia, mild elevated CRP, and microcytic hypochromic anemia, consistent with niacin deficiency. Treatment included niacinamide supplementation, B12 injections, proton pump inhibitors, and psychiatric counseling. Long-term management is essential to prevent relapse and associated complications.

Pseudoepitheliomatous keratotic and micaceous balanitis: a rare interesting case report

2025-01-04T19:19:55+0530

Pseudoepitheliomatous micaceous balanitis (PEKMB) is an uncommon non-venereal dermatosis primarily affecting males. PEKMB typically affects individuals above 50 years of age, with circumcision being a potential predisposer. Here, we report a case of a middle-aged male who was referred from the surgery department with genital lesions persisting even with treatment for 6 months. Clinical examination revealed hypopigmented to erythematous lesions with scaling over the glans penis, accompanied by urethral meatus narrowing. Despite conservative treatments on his own and with general practitioners, there was no improvement. Histopathological examination confirmed the features of PEKMB without malignancy. Treatment with topical emollients/ 5% 5 fluorouracil was initiated. Differential diagnoses include psoriasis, circinate balanitis, and malignant squamous epithelioma. Treatment options include topical steroids, 5% 5-fluorouracil cream, photodynamic therapy (PDT), etc. This case highlights the rarity of PEKMB and underscores the importance of early diagnosis and long-term follow-up.

A dive into gonorrhoea’s past

2025-01-04T19:19:53+0530

Gonorrhoea has a long-standing presence in human history, being recognized as one of the earliest sexually transmitted infections (STIs). While its exact origins are debated, there are references to a disease resembling gonorrhoea in ancient texts. The Chinese emperor Huang Ti mentioned a condition similar to gonorrhoea in his medical writings around 2600 BC. Additionally, some interpret passages in the book of Leviticus in the Old Testament as descriptions and precautions for gonorrhoea. Gonorrhoea, one of the oldest known STIs, has undergone significant changes in diagnosis and management over the centuries. Despite periods of decline, there has been a resurgence of the infection in recent decades. The emergence of drug-resistant strains and risky sexual behaviour may have contributed to this resurgence. To combat the spread of gonorrhoea, it's crucial to promote safe sex practices and provide comprehensive sex education, especially among teenagers. Timely adjustments to treatment regimens to address drug-resistant strains are also essential. By taking these steps, we can work towards reducing the prevalence and impact of gonorrhoea globally.

Crisaborole in dermatology

2025-01-04T19:19:58+0530

Crisaborole, though initially approved for the treatment of mild to moderate atopic dermatitis, has found its application in treatment of various other inflammatory dermatological conditions including psoriasis, vitiligo, stasis dermatitis, inflammatory verrucous epidermal nevus and more. This is due to the involvement of enzyme phosphodiesterase-4 and cyclic adenosine monophosphate (cAMP) in the pathogenesis of these disorders. Sources of study material included PubMed, National Library of Medicine, DermNet, Journal of the American Academy of Dermatology, manufacturer prescribing information and article bibliographies.This review article was prepared to show that crisaborole can be effectively used in treating those inflammatory dermatological disorders (as off-label indications) which are unresponsive to their first line treatment options. The side effects are minimal and tolerable. The only limitation is that the number of studies and case reports with crisaborole are very limited. Crisaborole seems to have promising results in the management of various inflammatory dermatological conditions with minimal side effects.

Predictors of vitamin B12 deficiency among patients with skin hyperpigmentation attending the dermatology clinic at Acharya Vinoba Bhave rural hospital Wardha, India

2025-01-04T19:19:50+0530

Background: India like any other developing country is grappling with malnutrition cases due to avoidable factors. Nutritional deficiencies are prevalent in India and hyperpigmentation due to micronutrient deficiencies are common. Prevalence of B12 deficiency varies from 3% to 5% in the general population. This study aimed to determine the predictors of vitamin B12 deficiency among patients with skin hyperpigmentation AVBRH hospital, India.

Methods: A cross-sectional study involving 164 patients with skin hyperpigmentation at dermatology department of AVBRH hospital, India was conducted from 1st April to June 30th 2024. Interviewer-administered questionnaires were used to obtained data and analysis was done using Stata version.

Results: Of the 164 respondents, 73(44%) had vitamin B12 deficiency. The mean plasma vitamin B12 level was 201 pg/ml among strict vegans as compared to 314 pg/ml in non-strict vegans. Young age (OR=7.1; 95%CI: 1.120-2.737; p=0.009), distance more than 5 kilometers from nearest health facility (OR=3.8, 95%CI: 0.024-0.187; p=0.005), not employed (OR=2.5, 95%CI: 0.731-4.071; p=0.026), being strict vegetarian (OR=2.1, 95%CI: 0.141-1.050; p=0.002), and number of meals less than 3 per day (OR=9.1; 95%CI: 3.14-7.320, p=0.005) were independently associated with vitamin B12 deficiency among patients with skin hyperpigmentation at AVBRH hospital, India.

Conclusions: The prevalence of Vitamin B12 deficiency among patients with skin hyperpigmentation is high in India. Young age, residing more than 5 kilometers from health facility, being a strict vegetarian, having less than 3 meals per day and unemployment are predictive for vitamin B12 deficiency among patients with skin hyperpigmentation at AVBRH hospital.

Skin health promoting effects of a proprietary nutraceutical ingredient (SesZen-BioTM): a placebo controlled, double-blind, and randomized clinical study

2025-01-04T19:20:12+0530

Background: This study evaluated the skin health benefits of SesZen-Bio^TM, a 0.5% natural biotin supplement derived from Sesbania grandiflora, previously linked to hair growth, in healthy adults aged 30-55 with mild skin ageing.

Methods: In a single-center, double-blind, placebo-controlled trial, participants between ages 30-55 years with mild skin ageing received either SesZen-Bio^TM or a placebo, with assessments conducted on days 0, 28, and 56. Parameters measured included facial wrinkles, fine lines, skin elasticity, hydration, skin barrier function and overall skin health.

Results: Significant reduction (p<0.01) in crow’s feet area by 27.11% (day 28) and 48.14% (day 56) and 17.95% and 51.17% reduction in fines lines were observed in the treatment group as compared to 12.1% reduction for placebo group at day 56. Physician global assessment (PGA) scores showed improvement in skin condition by 14.07% (day 28) and 20.58% (day 56) for SesZen-Bio^TMtreatment group. The facial skin tone assessment described by individual typology angle (ITA) showed lighter skin tone by 30.55% (day 28) and 58.23% (day 56) (p<0.01). Treatment group showed decrease in retraction time for skin elasticity on day 56, decreased skin roughness and increased skin hydration. Both groups showed decreased transepidermal water loss (TEWL) on both visits (days 28 and 56) as compared to baselines (p<0.01). The placebo group showed no improvement in PGA score, skin tone lightness (L*) and ITA score, skin hydration, or skin elasticity.

Conclusions: SesZen-Bio^TM appears to effectively promote skin health, reducing fine lines and improving skin tone, elasticity, and hydration, suggesting a viable strategy for combating skin aging and enhancing overall skin appearance.

A comparative evaluation of a commercially available kojic acid and arbutin-containing test product with a test regime in the treatment of hyperpigmentation

2025-01-04T19:20:09+0530

Background: The study compared the effectiveness of kojic acid and arbutin-containing lotion (alone) with arbutin-containing facewash and kojic acid and arbutin-containing lotion in the reduction of pigmentation.

Methods: The study compared the test product (lotion) and the test regime (lotion + facewash) over a period of 45 days. In both test groups, a thin layer of advance body lotion was applied to the face, neck, and upper trunk. In the test regime group (TRG), these areas were washed with advance facewash before the lotion was applied. Both groups used sunscreen (with a sun protection factor of 50). The primary outcomes measured were (i) skin radiance and skin pigmentation, (ii) skin gloss, and (iii) skin hydration. The secondary outcomes measured were clinical evaluation and a subjective self-assessment for tolerance and perception of the product.

Results: The study included 61 participants. The TRG showed a statistically significant increase in skin hydration (at 21 days) and skin gloss compared to the test product group (TPG) (at 21 and 45 days) (p<0.05). The majority of participants in both groups reported a visible reduction in pigmentation and improved facial glow and hydration as compared to baseline. No serious adverse effects were reported.

Conclusions: The use of kojic acid and arbutin-containing lotion alone and arbutin-containing facewash with the lotion led to significant improvements in skin radiance, lightening, gloss, and hydration as compared to the baseline, with the TRG showing significantly better clinical results than the TPG in terms of skin hydration and gloss.

Understanding the healthcare professionals’ perspective on the management of diabetic dry skin and the role of urea-based topical application

2025-01-04T19:20:06+0530

Background: Dermatological disorders are common in diabetes mellitus (DM), with xerosis affecting 40% of patients. Xerosis, characterized by scaling and dryness, can lead to complications such as cracks and infections. Urea-based moisturizers are effective in improving skin hydration and barrier function in diabetic patients. Objective was to evaluate the prevalence, awareness, and management of dry skin in diabetic patients and to assess healthcare professionals' (HCPs) perspectives and patients’ experience with urea-based topical treatments.

Methods: This questionnaire-based study involved 363 HCPs (dermatologists and cosmetologists) from India. Data were collected via an 18-question questionnaire in two phases (August and November 2023). The effect of urea-based formulations on diabetic skin dryness was assessed.

Results: Data were collected from 1,761 patients with DM, with 96.48% presenting with dry skin. While 48.83% of patients were aware of diabetes-related skin issues, 98.63% of them emphasized the importance of patient education on diabetes-related skin issues. Urea-based moisturizers were prescribed to 97.1% of patients, and 46.29% rated their efficacy as excellent. Most patients reported improvements in dryness and itchiness, with good overall tolerability (46.24%).

Conclusions: Urea-based moisturizers are effective and well-tolerated for managing dry skin in diabetic patients. HCPs view urea as essential for maintaining skin hydration and preventing complications associated with xerosis in DM.

Effects of clothes on hyperpigmentation and sunburn on people of India

2025-01-04T19:20:04+0530

Background: Many people suffer from sunburn and hyperpigmentation. Solar radiation can lead to hyperpigmentation as it easily triggers the production of melanin. Hyperpigmentation, sunburn and skin aging is determined by genetic aspects, lifestyle, and environmental factors. So, clothes likely to influence solar radiation related sufferings. The objective of the study is to test if suffering from solar radiation is associated with the nature of clothes used by the persons, what extent clothes can provide protection against solar radiation, and which type of clothes can provide maximum protection.

Methods: The Cohort study methods used for this study. The study done in two stages, first stage pilot study conducted to validate the instruments and methods used in the study. Second stage is the data collection and analysis for statistical testing and hypothesis testing.

Results: Persons wearing dark coloured loose and thick clothes covering most of their body parts can get 15 times more protection compared to the persons wearing light coloured tight and thin clothes covering less body parts.

Conclusions: People can protect themselves from solar radiation in an affordable manner by choosing appropriate clothing.

Use of topical corticost eroids in dermatological conditions: data from real world

2025-01-04T19:20:02+0530

Background: Topical corticosteroids (TCS) are the first treatment option prescribed for various dermatologic conditions. When used as monotherapy or combination therapy, TCS can efficiently alleviate the symptoms of atopic dermatitis and psoriasis. This electronic medical records (EMR) based study was planned to evaluate the TCS usage pattern in atopic dermatitis and psoriasis.

Methods: This was a real-world, retrospective, cross-sectional, EMR-based study where anonymized data of patients diagnosed with psoriasis (≥18 years) or atopic dermatitis (all age groups) and prescribed with TCS from 2017-2023 was extracted from the EMR database for analysis. Demographic characteristics of patients (age, gender), duration of the TCS prescribed, comorbid conditions and the concomitant medications prescribed with TCS were evaluated.

Results: Monotherapy (single TCS) was the most preferred. Clobetasol propionate, mometasone furoate and desonide were commonly prescribed. For psoriasis, a combination of TCS with non-steroidal molecules was most preferred. The most prescribed was the fixed-dose combination (FDC) of clobetasol propionate and salicylic acid. Antihistamines and emollients were the most common concomitant medications prescribed for atopic dermatitis patients. Antihistamines and immunosuppressants were the commonly prescribed concomitant medications for psoriasis patients.

Conclusions: It can be inferred from the findings of the study that TCS remain the mainstay for the treatment of atopic dermatitis and psoriasis. TCS monotherapy was preferred for atopic dermatitis while combination therapy emerged as the preferred approach for psoriasis patients.

Prevalence and determinants of acanthosis nigricans among adolescents: a school based cross sectional study in Southern Kerala

2025-01-04T19:19:48+0530

Background: Acanthosis nigricans (AN) is a dermatologic condition that may be associated with various underlying medical conditions and is increasingly seen in obese children and adolescents. Assessing AN in adolescents is crucial as it can serve as an early indicator of underlying insulin resistance and metabolic disorders.

Methods: This cross sectional study was conducted among class eleven higher secondary students in public and aided sector in Thiruvananthapuram district of Kerala. A total of 1832 students were recruited using multistage cluster sampling procedure. The participants were examined and neck grading for acanthosis was recorded. Anthropometric readings along with blood pressure, perceived stress levels, family history of diseases as well as life style habits were also evaluated. The female participants were examined for symptoms of anovulation and hyperandrogenism.

Results: A total of 1832 students participated in the study of which 66% were girls and 34% were boys. About 26% were found to have AN. Prevalence of Acanthosis was higher in girls (30.3%) compared to boys (18%). Hypertension (OR: 2.83, 95% CI: 2.25-3.55), overweight or obesity (OR: 10.67, 95% CI: 8.26-13.78) and high levels of perceived stress (OR: 1.55, 95% CI: 1.05-2.30) were found to be significantly associated with acanthosis.

Conclusions: The findings suggest that AN neck grading can serve as a useful tool for non-communicable disease screening in schools, enabling the identification of students who may require further evaluation and intervention.