International Journal of Research in Dermatology

Anxiety and depression in patients with chronic dermatologic diseases in Jordan: a cross-sectional study

Khitam Al-Refu — Tue, 21 Apr 2026 00:00:00 +0530

Background: Skin diseases can deeply affect patients’ mental health and social well-being, often more than what clinical assessments suggest. In the Middle East, data on the psychological burden of these conditions remain limited. This study aimed to evaluate anxiety and depression levels among Jordanian patients with common dermatologic conditions and explore their relationship with disease severity.

Methods: A total of 100 patients diagnosed with psoriasis, atopic dermatitis, acne vulgaris, rosacea, and alopecia areata were recruited, with 20 patients representing each condition. Disease severity was assessed using standardized scoring tools, including psoriasis area and severity index (PASI), scoring atopic dermatitis (SCORAD), global acne grading system (GAGS), clinician erythema assessment (CEA), and severity of alopecia tool (SALT). Psychological status was evaluated using the hospital anxiety and depression scale (HADS).

Results: Psychological symptoms were prevalent across all dermatologic conditions. Patients with mild acne and rosacea demonstrated the highest anxiety scores, while those with severe alopecia areata experienced the highest levels of depression. No direct correlation was observed between disease severity and psychological distress.

Conclusions: Chronic dermatologic conditions may be associated with significant psychological distress regardless of their clinical severity. These findings highlight the importance of incorporating mental health assessment into routine dermatologic care.

Assessment of primary skin irritation potential of Venusia cleanser: a human patch test study

Monil Gala, Snehal Muchhala, Gauri Dhanaki, Arti Sanghavi, Bhavesh Kotak — Tue, 21 Apr 2026 00:00:00 +0530

Background: This study aimed to evaluate the skin irritation potential of Venusia Cleanser using a standardized human patch test, with particularly in individuals with sensitive skin.

Methods: A monocentric, single-blind, controlled study was conducted in accordance with IS 4011: 2018 Methods of Test for Safety Evaluation of Cosmetics (Third Revision) and ICH-GCP guidelines. Healthy adults aged 18–65 years were enrolled, with 50% having sensitive skin based on the lactic acid sting test. Venusia Cleanser (8% dilution), 0.9% saline (negative control), and 1% sodium lauryl sulfate (SLS, positive control) were applied on the upper back for 24 hrs using a patch test. Patches were applied at Visit 1 and removed after 24 hrs at Visit 2. Draize scoring was done at 48 hours, with a 1-week follow-up to confirm recovery.

Results: Of the 26 participants, 25 completed the study (mean age 31.6 years; 13 males, 12 females; 13 with sensitive skin). At 48 hours, Venusia Cleanser (8% dilution) demonstrated a mean irritation score of 1.12, well below the IS 4011:2018 threshold of 2.0, confirming its non-irritancy. The positive control (1% SLS) showed marked irritancy (mean score 3.04), while saline (mean score 0.00) produced no reaction. No delayed reactions occurred, and the formulation was well tolerated in both the sensitive and normal skin groups.

Conclusions: Venusia Cleanser was demonstrated to be safe, well-tolerated, and non-irritant for sensitive skin. These findings reinforce its suitability for daily-use cleansers, particularly for gentle cleansing that helps maintain skin barrier integrity while minimizing irritation risk.

Kaposi’s sarcoma in North-East India: an under recognized burden

Sentila Longkumer, Leishiwon Kumrah, Aveni Koza, Nito Yepthomi — Tue, 21 Apr 2026 00:00:00 +0530

Background: Kaposi’s sarcoma (KS) is a rare AIDS-defining malignancy strongly associated with human herpesvirus 8 (HHV-8). Although KS is considered uncommon in India owing to its low HHV-8 seroprevalence, regions with high HIV prevalence, such as Northeast India, may exhibit a higher burden of KS. This study investigated the clinical characteristics and outcomes of KS cases in Nagaland, a region with a high HIV prevalence.

Methods: This retrospective observational study analyzed the demographics, clinical characteristics, and treatment outcomes of 16 KS cases diagnosed between 2011 and 2024 in Nagaland.

Results: The mean age of the patients was 45 years (±13.57) mean (±SD), and the male-to-female ratio was 1.7:1. Mucocutaneous lesions were the predominant presentation, while four patients exhibited pulmonary involvement. The median CD4 count at diagnosis was notably low at 54 cells/mm³ (IQR 47-262.5)). Six patients had coexisting opportunistic infections, such as tuberculosis, and two patients had Pneumocystis carinii pneumonia. Four patients improved with antiretroviral treatment (ART) alone, while four received liposomal doxorubicin along with ART, showing varying outcomes. Three patients died, likely due to systemic involvement and comorbidities. One patient was HIV-naïve, suggesting classic KS.

Conclusions: This study provides initial evidence that may challenge the previously held notion of KS rarity in India by documenting a notable burden in Nagaland, India. Increased vigilance is warranted in areas with high HIV prevalence, and further research is needed to understand the epidemiology and optimize treatment strategies in this region.

Clinical efficacy of a gentle anti-dandruff regimen

Tue, 21 Apr 2026 00:00:00 +0530

Background: This study is aimed to evaluate the efficacy and safety gentle anti-dandruff regime in the management of dandruff in healthy, Indian participants suffering from dandruff.

Methods: A total of 55 subjects with clinically diagnosed moderate dandruff were selected based on inclusion and exclusion criteria. Study was conducted in 3 phases, wash-off phase for 2 weeks, treatment phase for 4 weeks, followed by a regression phase of 1 week (during which anti-dandruff regime was withdrawn. Participants applied anti-dandruff regime on their scalp as per the instructions provided during the treatment (thrice a week). This is a regime of anti-dandruff shampoo and anti-dandruff scalp treatment.

Results: Regime showed reduction in dandruff flakes from first treatment and show improvement till the end of treatment phase, and maintained the lower dandruff levels below the baseline levels even after 1 week of product withdrawal. There were no reported side effects like oiliness/redness/irritation etc., during treatment and regression phase.

Conclusions: Anti-dandruff regime is a safe and highly effective solution designed to combat dandruff, while simultaneously improving overall health of the scalp and hair.

Evaluation of a sunscreen for phototoxic and photo-irritant potential via photo patch testing

Monil Gala, Snehal Muchhala, Gauri Dhanaki, Arti Sanghavi, Bhavesh Kotak — Tue, 21 Apr 2026 00:00:00 +0530

Background: Evaluation of the potential of Venusia Sun Unseen Sunscreen to induce phototoxicity (photo irritation) in adult participants, using a photo patch test technique.

Methods: This is a monocentric, non-randomised, single-application study to evaluate the potential of the Venusia sun unseen sunscreen to induce phototoxicity in adult participants, using a photo patch test technique. Two treatment sites were tested on the back of each subject and the grading was done for erythema/dryness/wrinkles (A) and oedema (O) reactions on the Draize scale. At both sites ~0.04 g of the test sunscreen was applied occlusively (T1 and T2) at visit 1. One additional site (C1) in the adjoining skin was exposed to ultraviolet (UV) light for the same period to act as a control (no product was applied on this site) for the UV exposure. At 24 hrs, T1 and C1 were UV-exposed and T1 reapplied; T2 stayed occlusive. All sites were scored at 48 hrs, with recovery confirmed at 1 week.

Results: The study included 26 healthy male and female participants aged 18-65 years. At 48 hrs, mean combined phototoxicity scores (A + O) were low across sites: 0.04 at control (C1), 0.75 at UV-exposed test site (T1), and 0.96 at unexposed test site (T2). No study-related adverse events (AEs) or intolerances were reported.

Conclusions: Venusia sun unseen sunscreen is well tolerated and suitable for long-term daily use, including in individuals with sensitive skin. Regular application helps reduce cumulative UV damage and lowers the risk of skin cancers.

Laser-based interventions for scarring alopecia: a meta-analytic review of clinical outcomes

Aishwarya Lakshmi Sekar, Sneha Thamilselvam, Aishwarya Devaraj, Nitin Katakam — Tue, 21 Apr 2026 00:00:00 +0530

Scarring alopecias are a group of inflammatory disorders resulting in irreversible hair loss and significant psychosocial burden. Standard therapies often yield incomplete responses, prompting exploration of alternative treatments. Laser-based therapies, including low-level laser therapy (LLLT), superluminescent diode (sLED) therapy, long-pulsed Nd:YAG, and excimer lasers, have emerged as potential options. This meta-analysis aims to evaluate the clinical effectiveness of laser-based interventions in treating scarring alopecias. A systematic search of PubMed, Cochrane CENTRAL, and Scopus was conducted, following PRISMA guidelines. Studies included were non-randomized clinical studies reporting outcomes after laser-based interventions for scarring alopecias. Data extraction and risk of bias assessment (ROBINS-I) were performed independently by two reviewers. Due to heterogeneity, descriptive synthesis and qualitative forest plots were generated. Seven studies involving 51 patients were included. Conditions studied included lichen planopilaris (LPP), frontal fibrosing alopecia (FFA), dissecting cellulitis (DCS), folliculitis decalvans (FD), and acne keloidalis nuchae (AKN). Laser interventions were associated with clinical or trichoscopic improvement in all studies. Two studies reported complete or near-complete disease remission. No significant adverse events were reported. Risk of bias was serious or critical in all studies, primarily due to small sample sizes and lack of controls. Laser-based therapies demonstrate promising clinical benefits in scarring alopecias, particularly in disease stabilization and symptom improvement. However, due to the high risk of bias and methodological limitations, high-quality randomized controlled trials are needed to confirm these findings.

Cutaneous clues to Kawasaki disease: observations from seventeen pediatric patients

Itzamar P. Echevarria, Vylma Velazquez — Tue, 21 Apr 2026 00:00:00 +0530

Kawasaki disease (KD) is an acute pediatric vasculitis and a leading cause of acquired heart disease. Cutaneous manifestations are central to its diagnosis, yet variability in rash morphology and distribution may delay recognition, particularly in incomplete cases. Objective of the study was to describe the frequency, morphology, and distribution of cutaneous manifestations in pediatric patients with KD at a tertiary care center in Puerto Rico. We conducted a retrospective case series of pediatric patients diagnosed with classic or incomplete KD at Hospital Episcopal San Lucas in Ponce, Puerto Rico, between January 2019 and December 2024. Patients meeting American Heart Association diagnostic criteria were included. Clinical data focused on rash morphology, distribution, timing, and desquamation. Seventeen patients were included. All patients presented with fever. A polymorphous rash was observed in 15 patients (88.2%), most commonly morbilliform in appearance (82.4%). One patient exhibited a scarlatiniform rash, and two patients (11.8%) did not develop a rash. Rash involvement most frequently affected the trunk and extremities (64.7%), followed by the face (41.2%). Inguinal or perineal involvement occurred in 17.6% of cases. Desquamation was documented in 41.2% of patients, predominantly as periungual peeling during the subacute phase. Twelve patients (70.6%) met criteria for complete KD, while five (29.4%) had incomplete presentations. Cutaneous manifestations were common and largely consistent with classic KD patterns. Recognition of early or subtle dermatologuc findings is essential particularly in incomplete KD to enable timely diagnosis and reduce coronary complications.

A retrospective case series on midface augmentation using hyaluronic acid fillers and combination therapies

Karishma Balani — Tue, 21 Apr 2026 00:00:00 +0530

Mid-face volume loss from skeletal resorption, soft-tissue atrophy, and reduced dermal support is a key feature of facial ageing. Hyaluronic acid fillers such as Restylane® offer predictable, minimally invasive contour restoration. Combination approaches with adjunctive therapies may enhance results. This retrospective case series reviews individualized multimodal plans for mid-face augmentation using Restylane® fillers. 5 adults (3 males, 2 females; 35–50 years) presented with moderate-to-severe mid-face volume loss with malar hollowing, prominent nasolabial folds, and reduced cheek projection. Treatment plans combined Restylane® fillers (Lyft, Classyc, Defyne, Volyme, Vital) with energy-based devices, botulinum toxin A, and chemical peels, tailored to anatomical needs. Assessments used global aesthetic improvement scale, Medicis midface volume scale, and wrinkle severity rating scale. All patients showed improved contour and skin quality with no adverse events. Multimodal protocols integrating Restylane® fillers with complementary treatments provide effective, individualized mid-face rejuvenation. Prospective studies are needed to validate these findings.

Familial epidermodysplasia verruciformis with intrafamilial phenotypic variability: a case series of three siblings

Surendra Singh Bhati, Apurva Mittal — Tue, 21 Apr 2026 00:00:00 +0530

Epidermodysplasia verruciformis is a rare inherited skin disorder characterized by persistent susceptibility to selected beta human papillomavirus types. The disease usually begins in childhood and follows a slow, progressive course, with lesions increasing in number and distribution over time. Clinical severity is variable and often unpredictable, even within the same family, and the risk of later malignant transformation remains a major concern. We describe three siblings from a single family diagnosed with epidermodysplasia verruciformis to demonstrate intrafamilial variability in clinical presentation. All patients underwent detailed clinical evaluation and family history assessment. Histopathological confirmation was obtained in one sibling, while diagnosis in the remaining two was made on the basis of characteristic clinical features in a familial setting. The index patient, a 19-year-old female, developed hypopigmented and hyperpigmented lesions at six years of age, with gradual involvement of the face, trunk, limbs, and external genitalia. Her elder brother had a similar age of onset but more extensive cutaneous involvement. The younger brother presented later, at ten years of age, with fewer lesions largely confined to the limbs. None of the siblings showed clinical evidence of malignant change at evaluation.

Beyond the usual suspects: a case of incontinentia pigmenti diagnosed after exhaustive exclusion

Tue, 21 Apr 2026 00:00:00 +0530

Incontinentia pigmenti (IP) is a rare X-linked dominant disorder caused by IKBKG gene mutations. Due to its rarity, early diagnosis is often delayed despite characteristic clinical features. A 12-day-old female born to healthy parents presented with an asymptomatic vesiculobullous rash following the lines of Blaschko. Present since birth, the tense blisters and bullae spread to the flexural extremities and genitalia, largely sparing the trunk. Hair, nails, and mucosa were unaffected. Tests revealed mild eosinophilia (12.6%), while comprehensive infectious screens were negative. A skin biopsy yielded nonspecific results, notably lacking melanin incontinence. Driven by strong clinical suspicion, genetic testing was performed. PCR amplification confirmed a common deletion within the IKBKG gene, successfully establishing the diagnosis. Managed with topical steroids and antibiotics, the lesions largely subsided by four months of age. This case underscores the importance of recognizing Blaschko-linear vesiculobullous lesions in neonates and highlights the critical role of genetic screening in confirming IP when the histopathology is inconclusive.