Indian Dermatology Online Journal最新文献

{"title":"Comparison of the Efficacy of Intralesional Methotrexate and Triamcinolone in the Treatment of Nail Psoriasis: A Randomized, Investigator-Blind, Controlled Trial.","authors":"Kourosh Ahmadi, Mozhdeh Sepaskhah, Zahra Bagheri, Roya Radanfar","doi":"10.4103/idoj.idoj_1017_24","DOIUrl":"https://doi.org/10.4103/idoj.idoj_1017_24","url":null,"abstract":"<p><strong>Background: </strong>Nail psoriasis is a common and challenging-to-treat manifestation of psoriasis. The efficacy of several medications has been studied in treating nail psoriasis with different results.</p><p><strong>Aim and objective: </strong>This trial assessed the therapeutic efficacy and safety of intralesional methotrexate injection compared to intralesional triamcinolone injection for nail psoriasis.</p><p><strong>Patients and methods: </strong>Seventeen patients (69 nails) were recruited in this investigator-blind, randomized, controlled trial, and 13 patients (65 nails) completed the study. The severity of the disease was evaluated by the modified Nail Psoriasis Severity Index (mNAPSI) before starting treatment, after each injection, and 8 weeks after the last injection. Thirty-three nails were randomly treated with methotrexate and 32 nails with triamcinolone. A volume of 0.1 mL of the diluted (5 mg/mL) triamcinolone (0.5 mg) or 0.05 mL of methotrexate (1.25 mg) was injected at each point every 3 weeks for four sessions. (Clinical trial registry: Iranian Registry of Clinical Trials. [ID: IRCT20140212016557N7]).</p><p><strong>Results: </strong>Both interventions significantly reduced the mNAPSI score ( P < 0.001). The percentage of reduction of mNAPSI score was more in the triamcinolone-treated nails at the end of treatment ( P = 0.015), but not significantly different in the 8-week follow-up ( P = 0.906). Deterioration of the mNAPSI score was seen only in the triamcinolone group at the end of 8 weeks after discontinuation of treatment ( P = 0.01).</p><p><strong>Limitations: </strong>A relatively small sample size, lack of prolonged follow-up, and absence of response assessment of the nail matrix and bed separately.</p><p><strong>Conclusion: </strong>Intralesional methotrexate is an effective and safe treatment for nail psoriasis, with similar efficacy to intralesional triamcinolone. Methotrexate showed more persistent efficacy compared to triamcinolone.</p>","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association between Vitiligo and Infections: A Systematic Review.","authors":"Shahnam Shamsabadi, Amirmohammad Bahri, Bahar Baridloghmani, Majid Khoshmirsafa","doi":"10.4103/idoj.idoj_302_25","DOIUrl":"https://doi.org/10.4103/idoj.idoj_302_25","url":null,"abstract":"<p><strong>Abstract: </strong>Vitiligo is an acquired depigmentation disease with an unknown etiology. Several theories on its etiology have been proposed, including autoimmune mechanisms, oxidative stress, genetic factors, environmental factors, and lack of melanocyte growth factor. Recent studies have demonstrated a possible correlation between microbial infections and the development or consequences of vitiligo. This study aims to investigate the potential association between microbial infections and vitiligo, focusing on identifying any explainable correlations between these two. A systematic search was performed on all publications evaluating the effects of viral, bacterial, parasitic, and fungal infections on vitiligo using online databases such as PubMed, Scopus, and Web of Science from 2010 up to June 2023 and followed the preferred reporting items for systematic review and meta-analysis (PRISMA) checklist. Viral infections, such as human immunodeficiency virus, varicella-zoster, and hepatitis C, are suggested triggers of vitiligo, potentially through immune dysregulation, cytokine imbalances, the Koebner phenomenon, and altered cellular immunity. Activation of MDA5 and vitamin D deficiency have also been proposed as mechanisms for virus-induced vitiligo. Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can dysregulate CD8+ lymphocytes and activate proinflammatory cytokines, disrupting immune tolerance and triggering or exacerbating vitiligo. Additionally, bystander activation triggered by coronavirus may cause an immune response against the host's melanocytes. Other factors such as Helicobacter pylori infection, endophytic bacterial and fungal infections, and vitamin D deficiency may also contribute to vitiligo pathogenesis by altering cellular immunity and systemic inflammation. Overall, a better understanding of the multiple factors that contribute to vitiligo may help inform more effective treatments and management strategies for this challenging condition.</p>","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Treatment with Methotrexate Versus a Combination of Low Dose of Methotrexate Plus Low Dose of Acitretin in Chronic Plaque Psoriasis: A Randomised Nonblinded Controlled Trial.","authors":"Satyendra K Singh, Sagnik De","doi":"10.4103/idoj.idoj_1317_25","DOIUrl":"https://doi.org/10.4103/idoj.idoj_1317_25","url":null,"abstract":"<p><strong>Background: </strong>Psoriasis is a chronic, inflammatory disease with no cure. Methotrexate (MTX) and acitretin (ACI) are well-established, FDA-approved systemic therapies for chronic plaque psoriasis. However, randomized trials evaluating their combination in fixed low doses are limited due to concerns of additive hepatotoxicity.</p><p><strong>Aim and objectives: </strong>To assess and compare efficacy and safety of treatment with MTX (0.3 mg/kg/week) versus low-dose MTX (0.15 mg/kg/week) plus low-dose ACI (0.3 mg/kg/day) in patients with chronic plaque psoriasis.</p><p><strong>Patients and methods: </strong>This was a nonblinded randomized controlled trial. Patients with chronic plaque psoriasis having body surface area (BSA)>10% and psoriasis area severity index (PASI)>10 were randomized into two groups. One group received intramuscular MTX 0.3 mg/kg/week, and the other received intramuscular MTX 0.15 mg/kg/week plus oral ACI 0.3 mg/kg/day. Patients were followed every 2 weeks for first 4 weeks and monthly thereafter till 16 weeks.</p><p><strong>Results: </strong>A total of 134 patients (67 in each group) were analyzed. Baseline BSA and PASI were comparable between groups ( P = 0.54 and P = 0.82, respectively) and showed significant reduction at 16 weeks in both arms ( P = 0.01 and P = 0.04). PASI-75, 90, and 100 at 16 weeks were slightly higher in monotherapy group but not statistically significant on per-protocol or intention-to-treat analyses. Onset of action was significantly earlier in monotherapy group ( P = 0.001). Laboratory and clinical adverse effects between groups were mild and manageable.</p><p><strong>Limitations: </strong>Nonblinded, absence of ACI monotherapy arm, limited study duration, and lack of noninvasive hepatic fibrosis assessment.</p><p><strong>Conclusion: </strong>Low-dose MTX plus ACI is a safe and effective alternative to standard-dose MTX in chronic plaque psoriasis, provided regular monitoring and follow-up are ensured.</p>","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of Serum and Tissue Eosinophils and Immunoglobulin E with Disease Severity in Bullous Pemphigoid: A Prospective Observational Study.","authors":"Kanimozhi Krishnamoorthy, Reena Rai, Sakthisankari Shanmugasundaram","doi":"10.4103/idoj.idoj_963_25","DOIUrl":"https://doi.org/10.4103/idoj.idoj_963_25","url":null,"abstract":"<p><strong>Background: </strong>Bullous pemphigoid (BP) is a subepidermal autoimmune blistering disorder in which eosinophils and immunoglobulin E (IgE) are implicated in disease pathogenesis and are potential markers of disease activity.</p><p><strong>Aim and objective: </strong>To evaluate the association of serum and tissue eosinophils and IgE levels with disease severity in BP.</p><p><strong>Patients and methods: </strong>A prospective observational study was conducted from October 2023 to December 2024 at a tertiary care center in South India. Thirty-five patients with clinically and histopathologically confirmed BP were included, disease severity was assessed using the bullous pemphigoid disease activity index (BPDAI). Serum eosinophil counts, serum IgE levels, histopathology, and direct immunofluorescence (DIF) findings for IgE deposition at the basement membrane zone (BMZ) were analyzed.</p><p><strong>Results: </strong>Higher disease activity (BPDAI >20/372) was observed in 77% of patients (27/35). Fisher's exact test showed no significant association between higher BPDAI scores and elevated serum eosinophil counts (>500 cells/μL), elevated serum IgE levels (>500 IU/mL) or DIF-detected IgE deposition at BMZ. However, biopsy evidence of eosinophil-predominant inflammatory infiltrates was significantly associated with higher disease activity (odds ratio [OR] =9.638; 95% confidence interval [CI]: 1.613-56.952; P = 0.029).</p><p><strong>Limitations: </strong>Small sample size, cross-sectional analysis, biopsy site variability and immunofluorescence methodology may have limited detection of IgE-related associations. Sample size calculation was based on the expected prevalence of IgE reactivity, but the significant association identified in our study involved tissue eosinophilia, for which the study was not specifically powered.</p><p><strong>Conclusion: </strong>Eosinophilic infiltration is strongly associated with BP severity, reinforcing its pathogenic role. Although serum IgE was frequently elevated, its correlation with severity was more evident when also detected in tissue.</p>","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin as Social Text: What Dermatology Teaches Us About Society.","authors":"Sagnik De, Satyendra K Singh","doi":"10.4103/idoj.idoj_1490_25","DOIUrl":"https://doi.org/10.4103/idoj.idoj_1490_25","url":null,"abstract":"","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Charcot Neuro-osteoarthropathy: Critical Concepts and Practical Management Pearls for Dermatologists.","authors":"Sejal Jain, Ashu Rastogi, Sunil Dogra, Tarun Narang","doi":"10.4103/idoj.idoj_1313_25","DOIUrl":"https://doi.org/10.4103/idoj.idoj_1313_25","url":null,"abstract":"<p><strong>Abstract: </strong>Charcot neuro-osteoarthropathy (CNO), formerly known as Charcot's arthropathy, is a progressive joint and bone disorder primarily affecting the bones of the feet. It usually occurs secondary to neuropathic damage from conditions like diabetes and leprosy. This chronic condition evolves through acute inflammatory and later chronic phases, characterized by joint destruction and instability. Pathophysiological mechanisms involve neurotraumatic and neurovascular theories, along with newer insights such as altered neuropeptide signaling, including calcitonin gene-related peptide, and dysregulation of the osteoprotegerin pathway, leading to increased osteoclastic activity and bone resorption. Clinical presentation ranges from acute inflammation marked by swelling, erythema, and warmth to chronic stages characterized by pain, joint deformities, and functional impairment. Diagnosis relies on clinical assessment, radiography, and magnetic resonance imaging for early detection and accurate staging. Management involves a multidisciplinary approach and includes conservative measures with total contact casting for offloading, and surgical options for severe deformities or recurrent ulcers. Early recognition and intervention are crucial to prevent progression and complications, emphasizing the role of dermatologists, especially leprologists, in timely diagnosis and management. In this review, we discuss the pathophysiology, clinical features, classification systems, investigations, and management of CNO.</p>","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Protocol-Driven Aspirin Desensitization with Comprehensive Hemodynamic and Laboratory Monitoring: A Case Report.","authors":"Arkit Singh, Ankur Gupta, Pankaj Khatri, Amol N Patil","doi":"10.4103/idoj.idoj_409_26","DOIUrl":"https://doi.org/10.4103/idoj.idoj_409_26","url":null,"abstract":"","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Febrile Asymptomatic Generalized Discrete Pigmentation in a Child with Isolated Epstein-Barr Virus IgM Positivity: A Rare Dermatologic Sequela.","authors":"Abhijit Saha, Subhra Dhar, Sharmistha Panja, Safia Bashir","doi":"10.4103/idoj.idoj_1062_25","DOIUrl":"https://doi.org/10.4103/idoj.idoj_1062_25","url":null,"abstract":"","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological Guideline for Online Surveys in Health Research.","authors":"Poojashree Rajaram, S Kavya, Yashashvi Goyal, Adhish K Sethi, Pvm Lakshmi","doi":"10.4103/idoj.idoj_1401_25","DOIUrl":"https://doi.org/10.4103/idoj.idoj_1401_25","url":null,"abstract":"<p><strong>Abstract: </strong>Online surveys have gained increasing importance in health research because they are affordable, scalable, and able to reach hard-to-access or stigmatized populations. Although they are widely used, there is still limited consolidated guidance on managing the methodological and ethical challenges associated with their use, especially within the Indian research context. This narrative review synthesizes existing literature on online survey methods to offer practical advice for researchers. We explored the methodological aspects of internet surveys, focusing on questionnaire design, ethical approval and informed consent, recruitment strategies, survey administration, response rate, and data analysis. Additionally, we summarize the features, costs, and suitability of nine commonly used internet survey platforms. Online surveys have evolved into user-friendly platforms that offer efficiency and inclusivity, yet challenges persist. We highlight evidence-based strategies to mitigate these challenges. Overall, this review stresses the importance of combining easy-to-use digital technology with research standards and ethical practices to produce reliable and impactful findings that can inform both academic and practical applications.</p>","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete Clearance of Lymphocytoma Cutis Following Punch Biopsy - Could it be Reverse Koebner's Phenomenon?","authors":"Bhumesh K Katakam, Manogna Vellala, Deepika Enugala, Ananthula V Krishna","doi":"10.4103/idoj.idoj_627_25","DOIUrl":"https://doi.org/10.4103/idoj.idoj_627_25","url":null,"abstract":"","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}