International Journal of Research in Dermatology

Providing comprehensive psychosocial care for adolescents with keloids in dermatology practice

Mon, 24 Feb 2025 00:00:00 +0530

Keloids, characterized by excessive collagen deposition resulting in raised and often painful scars, profoundly affect the psychosocial well-being of adolescents, leading to anxiety, depression, and social withdrawal during a critical period of identity formation. Current literature highlights these challenges but lacks comprehensive management strategies within dermatological practice. This review identifies the need for integrated care models that combine clinical treatment with mental health support, including routine psychosocial screening, immediate counseling referrals, and adolescent-specific education programs on keloid management and emotional coping. Training dermatologists to recognize psychological distress and adopt compassionate communication is essential. Collaborative research should focus on evaluating these integrative care models and developing evidence-based guidelines. By pioneering these comprehensive strategies, dermatology practices can improve physical outcomes and significantly enhance the quality of life for adolescents with keloids, addressing both the physical and psychological scars. Future research should prioritize the longitudinal impact of these interventions on mental health and treatment adherence, establishing a new standard of care that fully supports adolescent keloid patients. By implementing these comprehensive strategies, dermatology practices can enhance physical outcomes and significantly improve the quality of life for adolescents with keloids, addressing both the physical and psychological impacts in the management of keloids in this vulnerable population.

Unravelling the role of the skin microbiome in immunodermatological diseases: implications for therapeutic interventions

Haily Fritts, Kelly Frasier, Grace Herrick, Vivian Li, Elizabeth Sebastiao — Mon, 24 Feb 2025 00:00:00 +0530

The skin microbiome, comprising diverse microbial communities, is pivotal in maintaining cutaneous homeostasis and modulating immune responses in immunodermatological diseases. This review provides an overview of recent research investigating the interplay between the skin microbiome and autoimmune, allergic, and inflammatory skin conditions, such as psoriasis, eczema, and acne vulgaris. Current evidence suggests that alterations in the skin microbiome composition, termed dysbiosis, may contribute to disease pathogenesis and exacerbate inflammation in immunodermatological disorders. Furthermore, microbial-derived metabolites and immune-modulating factors produced by commensal bacteria can influence local immune responses and skin barrier function. Future research directions include evaluating how the skin microbiome interacts with the host immune system, identifying microbial biomarkers for disease diagnosis and prognosis, and exploring microbiome-targeted therapeutic interventions, such as probiotics, microbial transplantation, and microbial metabolite supplementation. By leveraging insights from microbiome research, personalized approaches to managing immunodermatological diseases may offer novel therapeutic avenues for restoring skin immune homeostasis and improving patient outcomes.

Evaluating the impact of high-dose vitamin D3, vitamin C, vitamin E, and zinc supplementation on inflammatory cytokines, lesion severity, and symptom management in hidradenitis suppurativa

Mon, 24 Feb 2025 00:00:00 +0530

This integrative, holistic review critically evaluates the impact of high-dose vitamin D3, vitamin C, vitamin E, and zinc supplementation on inflammatory cytokine levels, lesion severity, and symptom management in patients with hidradenitis suppurativa (HS). By integrating data from recent clinical trials and observational studies, we explore how these supplements influence key aspects of HS pathology. High-dose vitamin D3 has been shown to significantly reduce levels of inflammatory cytokines and decrease lesion severity, suggesting its role in modulating immune responses and improving disease outcomes. Similarly, the antioxidant properties of vitamins C and E are assessed for their ability to reduce oxidative stress and inflammation, which may lead to improved symptom management and reduced severity of HS lesions. Zinc supplementation, particularly in the form of zinc sulfate, is examined for its effects on enhancing skin barrier function and decreasing the frequency of disease flares. Collectively, these nutritional interventions may offer a multifaceted approach to HS management, highlighting the potential for combining these supplements to optimize therapeutic outcomes. The findings underscore the need for further research to determine the optimal dosing, duration, and interaction of these supplements with standard HS treatments to establish comprehensive management protocols.

The future of dermatology: integrating artificial intelligence into clinical practice

Nawaf Almutairi, Bakri Al Agraa, Zainab Mohamed — Mon, 24 Feb 2025 00:00:00 +0530

Dermatology has benefited considerably from the use of artificial intelligence (AI), which has emerged as a crucial tool in healthcare. Algorithms for machine learning (ML) and deep learning (DL), in particular convolutional neural networks (CNNs), have demonstrated significant promise in the diagnosis of skin disorders, classification of lesions, and telemedicine support. The use of AI in dermatology is examined in this paper, with particular attention paid to how it might improve patient care, increase access to dermatological treatments, and improve diagnostic accuracy. It also discusses the difficulties, moral dilemmas, and potential applications of AI in dermatology. It highlights the necessity of cooperation between researchers, practitioners, and regulatory agencies to guarantee a secure and efficient transition into clinical practice.

Innovative, affordable and easily obtainable ear pressure devices for keloid management

Mon, 24 Feb 2025 00:00:00 +0530

Keloids, characterized by excessive collagen production leading to raised, fibrous scars, present a persistent challenge in dermatological care, particularly when they affect sensitive areas such as the ear. This analysis introduces a thorough review of easily accessible specialized ear pressure devices designed to manage and prevent keloid formation through localized, controlled pressure application. These clips feature an advanced pressure-regulating mechanism that delivers consistent, low-level compression to the keloid-affected ear tissue, harnessing principles of mechanotransduction to reduce excessive collagen deposition and promote effective scar remodeling. Constructed from biocompatible, lightweight materials, the easy-to-obtain device features an adjustable fit to accommodate varying ear sizes and shapes, ensuring optimal pressure distribution and patient comfort. This design aims to minimize the need for invasive treatments by providing a non-surgical, patient-controlled method of keloid management. Preliminary research demonstrates improvements in keloid flattening and reduction in associated symptoms, such as itching and discomfort. Future research should focus on refining the device’s pressure modulation capabilities, exploring long-term efficacy across diverse patient populations, and evaluating its potential integration into comprehensive keloid treatment protocols. Easily accessible and affordable keloid pressure clips represent a significant advancement in keloid care, offering a targeted, minimally invasive solution with the potential to transform therapeutic approaches and improve patient outcomes in dermatology.

Comparative efficacy of trichloroacetic acid combined with silver nitrate and cryotherapy in treating plantar warts study in Military Medical Specialty Center

Zainab Mohamed, Ziad Aloukati, Rafea M. Al-Ghanem — Tue, 11 Feb 2025 00:00:00 +0530

Background: Warts are benign growths that affect the skin and mucous membranes. Comparative studies evaluating the efficacy of trichloroacetic acid (TCA), silver nitrate, and cryotherapy for treating plantar warts reveals distinct advantages for each treatment modality. Objectives were to determine the comparative efficacy of TCA with silver nitrate and cryotherapy in treating planter warts.

Methods: It was a descriptive, descriptive analytical and cross-sectional hospital-based study conducted at MMSC. Data were analyzed by statistical package for social sciences (SPSS) version 26.

Results: Among the100 participants (82% male, 18% female). The age distribution showed that most participants were between 20-29 years (34%) and 30-39 years (33%). The duration of the disease was less than 3 months for (50%) participants, while (44%) had the disease for 3-6 months. Most participants were employed (89%), aged 20-39 years (67%), and had experienced plantar warts for less than six months (94%). Both groups achieved high rates of complete resolution (82% for TCA vs. 74% for cryotherapy), though the difference was not statistically significant. Recurrence was significantly lower in the TCA group (12%) compared to the cryotherapy group (38%). Treatment duration and side effects varied significantly between groups, with TCA showing shorter treatment durations and fewer side effects. Cryotherapy was associated with higher rates of moderate and severe side effects.

Conclusions: The study demonstrates that TCA with silver nitrate is more effective and has a better safety profile than cryotherapy for the treatment of plantar warts. These findings support the recommendation of trichloroacetic acid with silver nitrate as a first-line treatment option, particularly for patients with a high risk of recurrence or those who may be sensitive to the side effects of cryotherapy. Further research with larger sample sizes and longer follow-up periods are recommended to confirm these results and assess long-term outcomes.

Pattern of skin diseases seen in the dermatology clinic of Rivers State University Teaching Hospital, Port Harcourt, Nigeria

Mary N. Amaewhule — Mon, 24 Feb 2025 00:00:00 +0530

Background: Skin diseases are a source of significant health concern worldwide. Understanding its epidemiology is important for effective healthcare planning. In our hospital, this study is the first of its kind. This study examines the pattern and trends of skin diseases as seen in RSUTH.

Methods: Medical records of patients seen in the dermatology clinic of RSUTH between August 2020 and August 2021 were retrieved, recorded and analyzed with SPSS version 27.

Results: The total number of patients seen during this period was 294. However, 4 were excluded due to insufficient data leaving 290 persons. Of these, 189 were females, while 101 were males. Age range is between 6 months and 88 years Mean age is 31.6692±16.87406. Commonest group of skin disorders is infectious skin diseases, commonest diagnosis is Dermatophytosis followed by Acne vulgaris. The least diagnosed disorders are nail disorders and autoimmune disorders.

Conclusions: A wide variety of skin diseases were seen in the subjects during the period of study. Dermatophytosis was the commonest skin disease seen while nail disorders was the least prevalent.

Prevalence and patterns of comorbidities in psoriasis: a cross-sectional study from Bangladesh

Mon, 24 Feb 2025 00:00:00 +0530

Background: Psoriasis is a chronic inflammatory disorder marked by red, scaly patches on the skin, often causing itching. Psoriasis manifests in several forms, with plaque psoriasis being the most common. This condition affects the skin, nails, joints, and other systems, leading to significant comorbidities like cardiovascular and metabolic disorders. These comorbidities, seen in two-thirds of patients, highlight the systemic inflammatory nature of psoriasis. Understanding these associations is crucial for dermatologists to provide comprehensive care for affected individuals. The study aims to investigate the comorbidities associated with psoriasis.

Methods: This cross-sectional, observational study was conducted at the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, including 120 adult psoriasis patients over one year. Ethical approval and informed consent were obtained.

Results: The most common age group was 41-50 years (30%), and the mean age of 43.63±13.69 years. Males comprised 60% of the population. Disease duration was up to 5 years for 80% of participants. Hypertension was the most frequent comorbidity (50%), followed by obesity (41.67%), dyslipidemia (33.33%), diabetes mellitus (25%), and metabolic syndrome (16.67%). Chronic plaque psoriasis was most prevalent (66.67%). Severity distribution indicated that 75% had mild/moderate psoriasis. Comparisons revealed no significant differences in comorbidities across psoriasis types or severity groups.

Conclusions: The study highlights the significant burden of comorbidities among psoriasis patients, particularly hypertension, obesity, dyslipidemia, diabetes mellitus, and metabolic syndrome. These conditions were prevalent regardless of psoriasis type or severity, underscoring the systemic nature of psoriasis and the need for comprehensive patient management.

Association between Lactobacillus plantarum consumption and diabetic dermatopathy: a case-control study

Jose J. Alvarez Arroyo, Irvin Hernandez Sanchez — Mon, 24 Feb 2025 00:00:00 +0530

Background: Diabetic dermatopathy (DD) is a common skin complication in patients with type 2 diabetes mellitus, associated with microvascular alterations. Its treatment is limited, but probiotics such as Lactobacillus plantarum have shown potential in modulating inflammation and improving skin health. This study evaluated the association between Lactobacillus plantarum consumption and the presence of DD.

Methods: A case-control study was conducted with 150 patients recruited at Ticomán hospital, Mexico City. Cases included 50 patients with a clinical diagnosis of DD, while controls comprised 100 patients without evidence of the condition, matched by age and sex. Lactobacillus plantarum consumption was assessed through structured questionnaires and medical history reviews. Data were analyzed using logistic regression models to calculate odds ratios (OR) and 95% confidence intervals (95% CI).

Results: Lactobacillus plantarum consumption was less frequent in cases (20%) than in controls (30%). Analyses indicated a significant association between Lactobacillus plantarum consumption and a lower likelihood of developing DD (adjusted OR=0.60; 95% CI=0.37-0.97; p=0.034).

Conclusions: The consumption of Lactobacillus plantarum is associated with a lower likelihood of developing DD in patients with type 2 diabetes mellitus. These findings highlight the potential of probiotics as a non-invasive preventive intervention in this population.

Evaluation of the knowledge, attitudes and practices about sun exposure and sunscreen usage in outpatients attending a dermatology clinic in North India

Nidhi Sharma, Garvit Raina, Nitish Sharma — Mon, 24 Feb 2025 00:00:00 +0530

Background: Multiple studies are available from West, regarding knowledge, attitude and practices related to sun exposure and usage of sun protective measures, however there is a paucity of such studies in Asian population. India being a tropical country, receives abundant sunlight and Indians are chronically sun exposed. So, we planned to assess the knowledge and awareness about sun protective measures in patients from North India.

Methods: A cross-sectional survey using specially designed questionnaires was carried out. Descriptive and inferential statistics were used wherever appropriate.

Results: A total of 500 patients were included, with majority being females. The mean age was 48.41 years and Fitzpatrick skin type V (60.4%) was the most commonly observed. 68.2% respondents reported daily sun exposure while 31.8% had reported occasional sun exposure. 34.6% had less than 1 hour of exposure, 20.8% had exposure of 1-3 hours and 44.6% had sun exposure more than 3 hours per day. 88% patients were aware of the harmful effects of sunlight. 74% respondents were aware of the benefits of sunscreen but only 26% were using them. Only 6% of those who were using sunscreen, were using sufficient amount and only 4% were reapplying. Most common reason for not wearing sunscreen was lack of awareness (44%). The most common source for information in our participants was social media and television.

Conclusions: This study demonstrated that the knowledge and practice of usage of sunscreen was sub optimal, suggesting the need of awareness programs and targeted interventions to fill this gap.

Occupational skin dermatosis among dental lab technicians in Khartoum state, 2023-2024

Mon, 24 Feb 2025 00:00:00 +0530

Background: Occupational skin dermatosis is of a significant concern among dental lab technicians due to their exposure to chemicals and materials used in dental prosthetics. These exposures can lead to various skin conditions, impacting the health and productivity of the workforce. To determine the prevalence, clinical features and associated factors of occupational skin dermatosis among dental lab technicians in Khartoum State from 2023 to 2024.

Methods: A descriptive, observational, cross-sectional study was conducted among 171 dental lab technicians in Khartoum State. Data collection involved a structured questionnaire, including demographic information, clinical features of skin conditions and use of protective equipment. Analysis was performed using SPSS Version 26, with descriptive and inferential statistics applied to identify significant associations.

Results: Of the 171 participants, 85.4% reported work-related skin symptoms, with dry skin being the most prevalent symptom (100%). Contact with denture material, particularly methyl methacrylate (MMA), was implicated in all reported cases. The use of protective equipment was low, with only 34.2% of participants using gloves or masks regularly. The prevalence of symptoms was significantly associated with the use of MMA and inadequate protective measures.

Conclusions: The study underscores a high prevalence of occupational skin dermatosis among dental lab technicians in Khartoum State, highlighting the need for improved occupational health practices. Implementing training programs on the proper use of protective equipment and regular monitoring of skin health are recommended to mitigate these risks.

Expert perspectives on the role of kojic acid in the treatment of hyperpigmentation in dermatology practice in Indian settings

Manjula S., Krishna Kumar M. — Mon, 24 Feb 2025 00:00:00 +0530

Background: Despite several clinical studies regarding the effectiveness of kojic acid, there is a dearth of studies among clinicians. So, this study aims to gather expert opinions regarding the physician's perspective and preference on the role of kojic acid and its combination in treating hyperpigmentation in Indian settings.

Methods: This cross-sectional study utilized a multiple-response questionnaire of 24 questions designed to gather feedback, clinical observations and specialists' experiences in managing hyperpigmentation with kojic acid and its combinations in routine practice. The questionnaire was structured to capture expert opinion on the frequency of use, perceived efficacy, adverse effects and preferences for these combinations.

Results: The survey involved 375 clinicians, with the majority (45.87%) preferring kojic acid combinations for treating various indications, including melasma, hyperpigmentation and PIH. Approximately 44% of the respondents reported prescribing kojic acid with glycolic acid to 11-20% of their patients. For peri-orbital melanosis, half of the respondents (50.4%) recommended kojic acid as monotherapy for fewer than 10% of patients, while 39% suggested it for 11-20% of patients. Around 77% of clinicians preferred the combination of kojic acid and glycolic acid for melasma treatment and 68.27% occasionally recommended hydroquinone with kojic acid for melasma. The preferred formulation of kojic acid was a gel, chosen by 48.8% of clinicians, while 43% preferred a cream formulation.

Conclusions: This study highlights clinicians’ preference for kojic acid combinations, especially with glycolic acid, for treating hyperpigmentation, particularly melasma. Most clinicians prefer gel formulation. These findings emphasize the popularity of kojic acid, especially in combination therapies, for managing hyperpigmentation.

A real-world retrospective study to determine the safety and effectiveness of naftifine 2% cream in the treatment of Tinea cruris and Tinea corporis in Indian patients

Mon, 24 Feb 2025 00:00:00 +0530

Background: This real-world retrospective analysis of the case record forms (CRFs) was done to evaluate the safety, effectiveness, compliance, and tolerability of naftifine 2% cream in treating superficial infections, especially Tinea corporis and Tinea cruris, in Indian patients.

Methods: The data was collected from 158 dermatologists/physicians’ outpatient department in India, on using naftifine 2% cream in patients presenting with new or recurrent Tinea infections. The CRFs of 1258 patients who had previously visited the dermatology outpatient department from July 2023 to May 2024 and received naftifine 2% cream as monotherapy or in combination therapy at the discretion of the treating physician were included in the study.

Results: A total of 1,258 eligible CRFs were analyzed, revealing that 81% of patients treated with naftifine 2% cream achieved clinical cure, while 99.6% achieved mycological cure. Adverse events were reported in only 2.6% (n=33) of patients, and naftifine 2% cream treatment was well tolerated.

Conclusions: This retrospective study suggests that naftifine 2% cream is safe and effective in patients with superficial fungal infections, including Tinea corporis and Tinea cruris.

Clinicoepidemiological study of pre malignant and malignant lesions among patients attending the dermatology OPD in a tertiary care centre in Puducherry: a retrospective cross-sectional study

Trishna Vaishali M., Nithiyaa P., Sheron Christin Armel J. — Mon, 24 Feb 2025 00:00:00 +0530

Background: The growing prevalence of skin cancer worldwide can be understood as the result of increased exposure to ultraviolet radiation. Fitzpatrick skin type 1 and 2 are at higher risk. They are poorly studied in Asians. Skin cancers accounts for 20%-30% of neoplasms in Caucasians and 2%-4% in Asians. Three million cases of non-melanoma skin cancer and 132 thousand melanomas are diagnosed worldwide every year. The aim of the study is to study the profile of patients with premalignant and malignant skin lesions visiting the dermatology OPD in Puducherry for a period of 3 years.

Methods: Case records of 57,316 patients were studied. 82 case records of premalignant and malignant skin lesions were reviewed and analysed using SPSS software. The prevalence was calculated and also their distribution among age, gender and race was analysed.

Results: 82 cases with 93 premalignant and malignant skin lesions were recorded. 77.4% (n=72) were premalignant lesions and 22.5% (n=21) were malignant lesions. The commonest premalignant lesion was leukoplakia (n=38, 52.78%) followed by actinic Keratosis (n=31, 43.05%), keratoacanthoma (n=2, 2.78%) and Bowens disease (n=1, 1.39%). The commonest malignant tumor in the study was basal cell carcinoma (n=12, 57.14%), followed by squamous cell carcinoma (n=9, 42.86%). There were no melanomas or lymphomas reported during the study period.

Conclusions: The index of suspicion for the atypical presentations and earlier identification of the premalignant and malignant skin lesions can aid in the selection of appropriate treatment modality and thereby reducing their associated morbidity and mortality.

Unveiling the clinical profiles and triggers of adverse cutaneous drug reactions at Jagakarsa general hospital

Mon, 24 Feb 2025 00:00:00 +0530

Background: Adverse cutaneous drug reactions (ACDR) are common side effects of drug use. This study aims to analyze the characteristics of patients, clinical profiles and risk factors associated with ACDR in patients visiting the Emergency Department of RSUD Jagakarsa.

Methods: This study is a retrospective study by analyzing medical records of patients who experienced ACDR from November 2023 to October 2024. Variables analyzed included demographic data, clinical profiles, causative drugs, onset time and risk factors.

Results: There were 40 cases of ACDR with a higher prevalence in females. Patient age varied with a mean of 35.80±16.54 years. The most common clinical presentation was urticaria (42.5%), followed by angioedema (22.5%) and maculopapular rash (17.5%). The most common drugs causing ACDR were antibiotics (32.5%), NSAIDs (25%) and antihypertensives (12.5%). Most cases (70%) had an onset of less than 24 hours. Associated risk factors included a previous history of drug allergy and comorbidities such as diabetes mellitus and hypertension.

Conclusions: Increased awareness of ACDR and preventive efforts are needed to reduce the incidence and impact of ACDR.

In vitro hair study, to evaluate the performance of 1% selenium sulfide +3% salicylic acid shampoo compared to 2% ketoconazole +2% salicylic acid shampoo in improving hair smoothness, hair softness, hair moisture, hair shine, hair manageability and reducing the hair frizz

Mon, 24 Feb 2025 00:00:00 +0530

Background: Recently, there's been more focus on finding hair care products that improve quality, manageability, and scalp health. Different active ingredients are used in products to improve these properties, with selenium sulfide and salicylic acid being important for their antifungal and keratolytic effects. Therefore, this study evaluates the efficacy of a novel hair care formulation, 1% selenium sulfide and 3% salicylic acid shampoo (Product A), in improving hair quality compared to a benchmark product, 2% ketoconazole and 2% salicylic acid shampoo (Product B). The main goal was to evaluate the impact of these formulations on hair smoothness, softness, moisture, shine, manageability, and frizz reduction through an in-vitro hair swatch study.

Methods: The study involved baseline treatment followed by the application of the respective shampoos, with subsequent evaluation of hair quality parameters by a trained expert panel.

Results: Results indicated that both products significantly improved hair smoothness and softness. However, product A outperformed product B in hair manageability and frizz reduction, with a 20% improvement in manageability and a 32% reduction in frizz. Product B, while showing greater improvement in moisture retention (13% vs. 6%), experienced a decline in shine, whereas product A maintained shine levels.

Conclusions: Statistical analysis revealed significant differences in performance, with product A showing superior results overall. These findings suggest that product A offers a more balanced and effective solution for hair care, particularly in manageability and frizz control. Further research, including clinical trials, is recommended to validate these results and explore long-term effects.

Evaluation of safety and efficacy of prickly heat baby powder in 0-36 months babies

Mohit Poddar, Sachin Bhargava, Mukund Sangamnerkar, Rajesh Kumawat — Mon, 24 Feb 2025 00:00:00 +0530

Background: Given the unique sensitivity of baby skin, this study emphasizes the importance of effective skincare products that cater to the delicate nature of young children's skin. This study was conducted to evaluate the safety, tolerability and efficacy of "Prickly Heat Baby Powder," a polyherbal formulation designed to alleviate symptoms associated with prickly heat in infants and toddlers.

Methods: This was an open-label, single-arm, multicentric study was conducted across 24 medical facilities in India, the trial involved 500 healthy full-term newborns, infants and toddlers aged 0–36 months. Over a 15 (+1) day period, parents/LAR were instructed to apply the powder after bath and nappy changes.

Results: The study assessed product tolerability and efficacy through paediatric evaluations and subjective feedback from parents. Results indicated that 68.6% of subjects experienced significant symptom resolution, with the product rated as mild and gentle for infant skin. No adverse effects were reported and a high acceptance rate was noted among subjects.

Conclusions: The formulation's natural ingredients, including Yashada bhasma, Neem, Karanja and Khus Khus, were highlighted for their antiseptic and anti-inflammatory properties, making it a safe alternative to conventional products. This study supports the potential of herbal formulations in paediatric dermatology and suggest that "Prickly Heat Baby Powder" effectively addresses the discomfort associated with prickly heat, aligning with the growing consumer preference for natural skin care solutions for children.

Psychosocial impact of melasma among Sudanese females attending Khartoum dermatology and venereology teaching hospital 2020-2021

Lena Mohamed Hamsa Ahmed, Bakri Al Alagraa, Nawaf Almuutairi, Zainab Mohamed — Mon, 24 Feb 2025 00:00:00 +0530

Background: Quality of life (QoL) is defined as capacity to perform the daily activities appropriate to person’s age and his/her major role in the society. Facial appearance plays an important role in self- perception and interaction with others and severe facial blemishes like melasma leave a deleterious impact on patient’s quality of life. This study aimed to assess Psychosocial impact of melasma among Sudanese females attending Khartoum Dermatology Teaching Hospital, 2020-2021.

Methods: This study was an observational cross sectional hospital based study conducted at Khartoum Dermatology and Venereology Teaching Hospital in 2020. The study included 135 melasma patients. In these patients the quality of life was assessed using the melasma quality of life measure (MELASQoL). Furthermore, the patients were evaluated using the melasma area and severity index (MSI). Data collected, were analyzed using SPSS version 25.0.

Results: More than half (59.6%) of melasma patients were in age group 20-30 years old and more than half (57.9%) of melasma patients were married. Majority (62.3%) of melasma patients had MASI score of less than 3. There was significant association between age and score, gender and score; hence p value was less than 0.05 (<0.05).

Conclusions: Improvement of early detection of impaired quality of life among melasma patients may provide. Effective management and prevention of this complication due to melasma.

Dermoscopic features in different types of lichen planus: a case series

Sudhir Kumar Singh, Akshara Kharabanda, Anchal Kundalia — Mon, 24 Feb 2025 00:00:00 +0530

Lichen planus is a chronic inflammatory skin disorder that affects the skin, scalp, nails, and mucous membranes. It is characterized by distinctive purplish, flat-topped papules, often accompanied by intense pruritus. The etiology of LP remains largely idiopathic, although immune-mediated mechanisms, including T-cell mediated responses, are thought to play a significant role in its pathogenesis. Its prevalence is estimated at 0.22% to 1% of the adult population, with oral lichen planus occurring in 1-4% of individuals. Dermoscopy is a useful non-invasive tool for evaluating lichen planus, allowing detailed visualization of skin lesions and aiding in diagnosis. This technique is particularly beneficial in cases where clinical evaluation alone might be insufficient. Dermoscopy not only supports the diagnosis but also provides insights into disease activity and progression, and identifying complications such as scarring or malignant transformation in rare cases. making it an essential tool for dermatologists in managing lichen planus. This paper explores various dermoscopic findings associated with different variants of lichen planus, including classical, actinic, planopilaris, pigmentosus and hypertrophic lichen planus (HLP).

Adjunctive use of VTAMA (tapinarof) 1% cream in the management of new-onset scalp psoriasis in a patient with fistulizing Crohn's disease on infliximab

Kyle T. Machynia — Thu, 16 Jan 2025 00:00:00 +0530

Psoriasis (PsO) frequently coexists with inflammatory bowel disease (IBD), including Crohn's disease (CD). Patients with CD on tumor necrosis factor (TNF)-alpha inhibitors, such as infliximab (IFX), are at an increased risk for developing PsO. The paradoxical development of PsO in this patient population presents a therapeutic challenge, particularly in those with fistulizing CD, as switching to IL-23 inhibitors is not a viable option due to their reduced efficacy in promoting fistula healing. Effective treatment strategies that can manage PsO without compromising CD control are therefore necessary. Here we report a case of new onset scalp PsO treated with tapinarof 1% cream with significant improvement noted after 2 weeks of application and maintains clearance of scalp PsO with biweekly application.

Multiple accessory tragi in a male child

Samuel Jeyaraj Daniel, J. Balaji Ganesh, S. Saranya, K. Desingh — Mon, 24 Feb 2025 00:00:00 +0530

Accessory tragus (AT) is a congenital abnormality of the external ear which was first described by Birkett in 1858. AT is typically found in the preauricular region, though it can also occur less commonly in the mandibular or cervical regions. This cartilaginous protrusion, commonly known as the preauricular tag, is a rudimentary tag of ear tissue. With an incidence rate of 0.2-0.5%, this abnormality is believed to be an autosomal dominant hereditary condition caused by an abnormality in the development of first or second branchial arch. Patients with accessory tragus are more likely to be males and typically appear unilaterally. It may exist alone or in groups with a distinct morphology and location. Here, we report a case of multiple accessory tragi in a male child affecting the tragus and cheek with no other malformations.

Melanonychia striata with lentiginous pigmentation: a rare case report

Mon, 24 Feb 2025 00:00:00 +0530

Melanonychia is characterized by brown to black discolouration of nail plate of the finger nail or toe nail due to pigment deposition. The aetiology of melanonychia ranges from benign causes that are nevus and lentigines to a malignant one like melanoma, which is however rare. Other aetiology includes post-traumatic, nutritional deficiency, infections, constitutional etc. We report here; a nine-year-old male child who presented to us with concern of pigmented nail bands. A dermoscopic and histopathological evaluation indicated the presence of an intradermal nevus along with concurrent lentiginous pigmentation, which is a rare occurrence.

A rare case report on linezolid induced fixed drug eruption

T. Amul Prathap, D. Lokeshvaran, D. G. Abinish, S. Kalaivani, J. Aswin — Mon, 24 Feb 2025 00:00:00 +0530

Fixed drug eruption is a rare but significant adverse drug reaction characterized by recurrent, well-defined skin lesions that consistently reappear at the same anatomical sites upon re-exposure to the offending drug. This case report presents a 48-year-old female who developed hyperpigmented patches on her left thigh and axilla followed by the administration of linezolid, an antibiotic used for treating resistant gram-positive bacterial infections. Although Linezolid is generally well-tolerated, it can cause cutaneous reactions, with fixed drug eruptions being an exceedingly rare occurrence. The patient's condition improved significantly after discontinuation of linezolid and treatment with corticosteroids, antihistamines, and topical agents. This case underscores the importance for clinicians to consider FDE in the differential diagnosis of patients receiving linezolid, particularly when lesions appear in atypical locations such as the thigh and axilla. Additionally, it emphasizes the critical role of prompt drug cessation and appropriate symptomatic treatment in managing such adverse reactions, thereby improving patient outcomes and ensuring better clinical management.

Congenital Beckers nevus overlying plexiform neurofibroma in neurofibromatosis type-1: more than a rare association

Mon, 24 Feb 2025 00:00:00 +0530

Plexiform neurofibroma (PFN) is the hallmark of Neurofibromatosis type 1 (NF-1), an autosomal dominant disorder caused by mutations in the neurofibromin gene.1 Becker's nevus (BN) is an acquired pigmentary disorder characterized by hyperpigmentation and hypertrichosis, presenting in adolescence.2 Here we present a 28-year-old male with a congenital hyperpigmented pigmented patch over his back which later on increased in size and developed excessive hair growth and subsequently swelling. The patient had no other swellings of neurofibroma but satisfied all the criteria of Type-1 Neurofibromatosis. Clinical, dermoscopic and histopathologic features confirmed the diagnosis of PFN with BN in NF-1. Two special stains including S-100 and Fontana Mason stain ruled out other possibilities and further confirmed the diagnosis of Congenital Becker’s Nevus with Plexiform Neurofibroma in NF-1. The report emphasizes that in NF-1, Becker’s nevus can masquerade an ominous presence of plexiform neurofibroma. The case has been reported for the rarity of association of Congenital Beckers Nevus with Plexiform Neurofibroma in NF-1.

Pretibial myxoedema: a case study of a 49-year-old male

Mon, 24 Feb 2025 00:00:00 +0530

Pretibial myxoedema (PTM), also known as thyroid dermopathy, is a rare but distinctive complication of Graves’ disease, often appearing as skin lesions on the shins. A 49-year-old male with thyrotoxicosis and diabetes presented with significant swelling in his lower legs, including the shins, ankles, and feet. Laboratory tests revealed normal thyroid function but elevated thyroid-stimulating hormone (TSH) receptor antibodies, confirming PTM diagnosis upon biopsy. Thyroid dermopathy is usually asymptomatic, but severe cases may result in elephantiasis or thyroid acropachy, often accompanying ophthalmopathy, which typically appears earlier. Diagnosis is made by identifying characteristic lesions in patients with a history of Graves' disease and ophthalmopathy, sometimes requiring biopsy for confirmation. Though many cases are mild and self-resolving, topical corticosteroids can provide relief in symptomatic or cosmetically concerning cases. In severe instances, systemic immunomodulation may be required, though evidence supporting its long-term efficacy is limited. The underlying pathogenesis involves immune-mediated fibroblast activation and glycosaminoglycan (GAG) production, particularly in the pretibial area due to mechanical factors. Studies show that subclinical dermopathy can occur in untreated Graves' disease, though histological changes in other areas like the forearm remain rare. Overall, treatment remains largely palliative, with more effective options still needed.