Indian Dermatology Online Journal最新文献

{"title":"Comparison of the Efficacy of Topical Methotrexate 1% gel Versus Topical Betamethasone Dipropionate 0.05% Lotion in the Treatment of Localized Scalp Alopecia Areata in a Tertiary Care Institute of Central India: A Randomized Control Trial.","authors":"Susmita Banra, Neel Prabha, Soumil Khare","doi":"10.4103/idoj.idoj_212_24","DOIUrl":"10.4103/idoj.idoj_212_24","url":null,"abstract":"<p><strong>Background: </strong>The first line of therapy for limited patchy alopecia areata is topical corticosteroids. Recently, topical methotrexate has been found effective in alopecia areata.</p><p><strong>Objective: </strong>To compare the efficacy between topical methotrexate and betamethasone dipropionate lotion in the treatment of localized scalp alopecia areata.</p><p><strong>Patients and methods: </strong>Seventy patients with localized scalp alopecia areata were randomized by block randomization in a 1:1 ratio to two groups. Group A received methotrexate 1% gel twice daily, and group B received betamethasone dipropionate 0.05% lotion twice daily for 12 weeks or until a hair regrowth score of 5 was achieved.</p><p><strong>Results: </strong>Fifty-six patients completed the trial. In the per-protocol analysis, no significant difference was seen in the decrease in severity of alopecia tool (SALT) score between group A and group B. The median (25 th -75 th percentile) modified hair regrowth scale at 4 weeks and 12 weeks in group A was 1 (0-2) and 4 (3.5-5), respectively. In group B, it was 1 (0-1.5) and 4 (3-5), respectively, with no significant difference between them. Mild and tolerable side effects were seen in both groups. Irritant dermatitis was seen in 31.03% of patients in group A. Itching was reported in 16 patients in group A as compared to 4 patients in group B, which was statistically significant ( P value = 0.002).</p><p><strong>Limitations: </strong>Few patients were lost to follow-up and patients were not followed up after stopping treatment to assess the long-term treatment response or relapse.</p><p><strong>Conclusion: </strong>Both methotrexate gel and betamethasone lotion are effective and safe treatments for localized alopecia areata, showing comparable overall response rates. However, local side effects are more common with methotrexate gel than with betamethasone lotion. This study suggests that methotrexate gel can be considered one of the topical treatment options for localized alopecia areata.</p>","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855115","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":"Estimation of Serum Vitamin D Levels and Helminthic Coinfection in Patients with Type 2 Lepra Reactions and Its Correlation with Severity of Type 2 Reactions: A Cross-Sectional Study.","authors":"Nupoor Nayak, Prasenjeet Mohanty, Jayashree Mohanty, Pratima K Sahu, Nihar R Pati, Siddhartha Dash","doi":"10.4103/idoj.idoj_925_24","DOIUrl":"10.4103/idoj.idoj_925_24","url":null,"abstract":"<p><strong>Background: </strong>Manifestations of leprosy are largely driven by host immune response, with the lepra reactions complicating the indolent course of the disease. Research indicates that the biological processes linked to vitamin deficiencies and helminth infections increase susceptibility to other infections.</p><p><strong>Aims and objectives: </strong>To estimate serum vitamin D levels and helminthic coinfections in patients with type 2 lepra reactions and their correlation with the severity of type 2 lepra reactions.</p><p><strong>Patients and methods: </strong>A prospective cross-sectional study involving 75 leprosy patients of all ages with type 2 reactions, was conducted at a tertiary health care center for 18 months. Serum vitamin D was estimated and stool wet-mount examination was performed to look for the presence of helminth ova. The severity of type 2 reaction was measured by a modified ENLIST erythema nodosum leprosum (ENL) severity scale.</p><p><strong>Results: </strong>Out of 75 patients, 76% ( n = 57) were males and the most affected age group was 31-40 years. In total, 70.6% ( n = 53) of patients had lepromatous leprosy, while the rest had borderline lepromatous leprosy. ENLIST score showed severe ENL in 47 (62.7%) patients. Ova of helminths were found in 17.3% ( n = 13) patients, two of which were Ascaris lumbricoides and the rest were Ankylostoma duodenale . Vitamin D deficiency was seen in 23 (30.7%) patients, insufficient levels were found in 33 (44%) patients, and the association with ENLIST score was found to be statistically significant ( P < 0.05).</p><p><strong>Limitations: </strong>The limitations include a small sample size and a cross-sectional study design. Estimation of serum vitamin D levels in age and sex-matched controls could have eliminated the confounders. Additionally, as patients were not followed up, it remains unclear whether vitamin supplementation and deworming reduced the frequency or severity of reaction episodes.</p><p><strong>Conclusion: </strong>The above correlation implies that the immune consequences of vitamin D deficiency and helminthic coinfection may increase the risk of active leprosy and the severity of lepra reactions.</p>","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855117","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":"Phototherapy with Topical Minoxidil in Vitiligo: A Randomized Control Trial.","authors":"Sejal Bajoria, Chakravarthi R Srinivas, Nithya Satish, Riya Sukhija, Kriti Jain, Garima Manocha, Laxman Besra","doi":"10.4103/idoj.idoj_1242_24","DOIUrl":"10.4103/idoj.idoj_1242_24","url":null,"abstract":"<p><strong>Background: </strong>Phototherapy is the most commonly used treatment for vitiligo, with initial pigment appearing at the perifollicular site, eventually coalescing into uniform pigmentation due to melanocyte migration from hair follicles. Melanocyte activity is higher during the anagen phase of the hair cycle, which is prolonged by minoxidil.</p><p><strong>Aim: </strong>To assess if topical minoxidil enhances the rate of pigmentation during phototherapy for the treatment of vitiligo.</p><p><strong>Patients and methods: </strong>In this double-blinded, randomized control study, the efficacy of minoxidil in inducing repigmentation was compared with the vehicle used as a placebo. Thirty vitiligo patients with a minimum of 2 patches were included and randomized into 2 groups and treated with phototherapy. Minoxidil 5% solution was randomly applied on one patch and vehicle on the other patch. The vitiligo area severity index (VASI) score of the lesion was measured at baseline and then at 4, 8, and 12 weeks for each lesion. Physician and patient global assessment scores were recorded at week 12.</p><p><strong>Results: </strong>In minoxidil group, the baseline VASI score of 94 ± 9.68% reduced to 47.76 ± 17.25% at 12 weeks. In the placebo group, the VASI score reduced from 94 ± 9.68% to 67.93 ± 16.88%. Reduction in VASI was found to be greater in minoxidil group as compared with the placebo group ( P value = <0.001). The difference in the physician and patient's global assessment scores in both minoxidil and placebo groups was also statistically significant.</p><p><strong>Limitations: </strong>The study had a small sample size and a short follow-up period.</p><p><strong>Conclusion: </strong>Concomitant use of phototherapy and minoxidil increases the rate of pigmentation with reduction in VASI score.</p>","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855121","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":"Subcutaneous Soft Tissue Chondroma with Extensive Myxoid Changes: A Diagnostic Challenge.","authors":"Venkat Shashidhar Chittapragada, Nivetha Ambalavanan, Anindita Sinha, Satya Swaroop Tripathy, Debajyoti Chatterjee","doi":"10.4103/idoj.idoj_1073_24","DOIUrl":"https://doi.org/10.4103/idoj.idoj_1073_24","url":null,"abstract":"","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834996","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":"Comparison of Dermoscopy and Wood's Lamp in the Assessment of Stability of Vitiligo.","authors":"Alaka J Mohan, Abdulsalam Sarin, Ajithkumar Kidangazhiathmana, Neelakandhan Asokan","doi":"10.4103/idoj.idoj_728_24","DOIUrl":"https://doi.org/10.4103/idoj.idoj_728_24","url":null,"abstract":"<p><strong>Background: </strong>The stability of vitiligo is mainly assessed using clinical criteria. Wood's lamp and dermoscopy have been proposed as valuable alternatives.</p><p><strong>Objective: </strong>The objective of the study was to compare the utility of dermoscopy and Wood's lamp examination in the assessment of stability in vitiligo compared with clinical criteria and to define the best cutoff score using BPLeFoSK criteria in determining vitiligo stability.</p><p><strong>Patients and methods: </strong>The study was conducted among patients with vitiligo attending a tertiary care center. The study design was a diagnostic test evaluation. One hundred and ten patients with vitiligo were recruited over 18 months. The most recent lesion in each patient was assessed for its stability using the clinical evaluation, Vitiligo Disease Activity (VIDA) score, Wood's lamp, and dermoscopy with the BPLeFoSK score, where a score ≥1.5 indicated stable vitiligo.</p><p><strong>Results: </strong>The study revealed moderate agreement between Wood's lamp and dermoscopy (κ=0.55) and a fair agreement between clinical evaluation and both Wood's lamp (κ=0.33) and dermoscopy (κ=0.40). Wood's lamp showed 72.3% sensitivity and 66.7% specificity, while dermoscopy had 74.1% sensitivity and 73.5% specificity. Wood's lamp had 87% accuracy in identifying stable vitiligo but only 43.9% accuracy in ruling it out compared to clinical criteria. Dermoscopy demonstrated slightly higher effectiveness. The area under the receiver operating characteristic curve for dermoscopy versus clinical criteria was 0.826, while Wood's lamp scored 0.695. A BPLeFoSK cutoff score of ≥3.5 was specific (97.6%) for identifying stable vitiligo, but sensitivity was low (25.6%).</p><p><strong>Limitations: </strong>The study's limitations included the cross-sectional study design, examination of only one lesion per patient, lack of blinding, absence of follow-up, absence of histopathologic examination of the lesions, lack of sequential observation through a combination of clinical, dermoscopic, or Wood's lamp examination, and utilization of VIDA scoring system which itself has recall bias. Use of a non-validated scoring system (BPLeFoSK) is also a limitation of this study.</p><p><strong>Conclusion: </strong>This study shows that dermoscopy and Wood's lamp are equally helpful in clinical assessment. We propose a cutoff score of more than or equal to 3.5 in BPLeFoSK score.</p>","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834993","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":"Insights into the Impact of Artificial Intelligence on Psoriasis Treatment Strategies: A Mini Review.","authors":"A Prithiviraj, M A Aarthi, N Venkateswaramurthy","doi":"10.4103/idoj.idoj_1055_24","DOIUrl":"https://doi.org/10.4103/idoj.idoj_1055_24","url":null,"abstract":"<p><strong>Abstract: </strong>Psoriasis is a chronic inflammatory skin condition affecting millions of people globally, with prevalence varying significantly between countries. Conventional treatments, including topical agents, phototherapy, and systemic medications, often fail to account for individual variability, leading to suboptimal outcomes and potential adverse effects. Artificial intelligence (AI) has emerged as a promising approach to enhance precision and personalization in psoriasis management, potentially transforming diagnostic accuracy and treatment selection. This review examines the integration of AI across multiple domains of psoriasis treatment: (1) machine learning algorithms for phototherapy outcome prediction, (2) deep learning techniques for lesion segmentation and severity assessment, (3) AI-enhanced remote photographic monitoring systems, and (4) predictive modeling for response to systemic therapies and biologics. The analysis encompasses various AI methodologies, including random forest classifiers, convolutional neural networks, multiscale superpixel clustering, and gradient-boosted decision trees applied to clinical datasets, imaging analysis, and multi-omic patient data. AI-driven models demonstrate significant clinical utility with phototherapy outcome prediction, achieving high sensitivity (>84%) and accuracy (75-85%). Automated lesion segmentation reaches 86.99%-pixel accuracy, while remote AI assessments strongly correlate with clinical evaluations (Intraclass Correlation Coefficient [ICC] = 0.78-0.99). Notably, predictive models can forecast biologic therapy responses with > 95% accuracy within 2-4 weeks of treatment initiation, substantially reducing evaluation timelines from the conventional 12-week assessment period. AI technologies offer transformative potential in psoriasis management by enabling precise diagnosis, outcome prediction, and personalized therapy selection. Current implementations show promising results across diverse clinical applications, from phototherapy optimization to biologic response prediction. While challenges in dataset diversity, standardization, and validation remain, these represent opportunities for further advancement toward precision medicine in dermatology.</p>","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816502","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":"Cough Purpura.","authors":"Rohit Kothari","doi":"10.4103/idoj.idoj_1136_24","DOIUrl":"https://doi.org/10.4103/idoj.idoj_1136_24","url":null,"abstract":"","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794324","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":"Cutaneous Manifestations of Parvovirus B19: A Quick Review in the Wake of the Recent Outbreak Across Various Regions.","authors":"Anuradha Bishnoi, Hitaishi Mehta, Keshavamurthy Vinay","doi":"10.4103/idoj.idoj_1138_24","DOIUrl":"https://doi.org/10.4103/idoj.idoj_1138_24","url":null,"abstract":"","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794325","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 Child with Bilaterally Symmetrical Papulosquamous Lesions.","authors":"Abhijit Saha, Swarnali Maiti, Safia Bashir","doi":"10.4103/idoj.idoj_921_24","DOIUrl":"https://doi.org/10.4103/idoj.idoj_921_24","url":null,"abstract":"","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794323","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":"Phlebolith.","authors":"Suruthi Purushothaman, Raveendiran Gopal, Sheetanshu Kumar","doi":"10.4103/idoj.idoj_1123_24","DOIUrl":"https://doi.org/10.4103/idoj.idoj_1123_24","url":null,"abstract":"","PeriodicalId":13335,"journal":{"name":"Indian Dermatology Online Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794328","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}