Indian Journal of Dermatology最新文献

{"title":"Effectiveness, Tolerability and Safety of Topical Clobetasol with Oral Hydroxychloroquine versus Topical Clobetasol with NBUVB Phototherapy in Unstable Vitiligo: Investigator Blind, Randomized Controlled Trial.","authors":"Dhiman Tarafdar, Indrayudh Sen, Sankha Koley, Biswarup Ray, Pinaki Sarkar, Amrita Sil, Arghyaprasun Ghosh, Nilay K Das","doi":"10.4103/ijd.ijd_78_24","DOIUrl":"10.4103/ijd.ijd_78_24","url":null,"abstract":"<p><strong>Background: </strong>Vitiligo is an acquired multifactorial depigmentation disorder with dreadful social stigma without any gold standard treatment option. Treatment of unstable vitiligo is, furthermore limited. Hydroxychloroquine has shown promise in a few case reports.</p><p><strong>Objectives: </strong>The effectiveness, tolerability and safety of narrow-band ultraviolet B (NBUVB)-plus topical clobetasol (group A) versus oral hydroxychloroquine-plus topical clobetasol (0.05%) (group B) were evaluated.</p><p><strong>Methods: </strong>Single-centre, investigator-blind, randomised, active-controlled, parallel-group phase IV trial (CTRI/2019/07/020345) was conducted on unstable vitiligo of either sex. Patients were randomised into two groups (1:1 allocation ratio), and allocation concealment was ensured by the sequentially numbered, sealed, opaque envelope technique. The assessing physician was unaware regarding treatment allocation. Outcome measures were the vitiligo area scoring index (VASI), vitiligo disease activity score (VIDA) and dermatology life quality index (DLQI). The economic burden of therapy was calculated in terms of travel costs and loss of time for availing of the therapy. Routine haematological and biochemical tests and treatment-emergent adverse events were monitored for safety. The calculated sample size was 82 (5% alpha-error, 80% power, 61.1% and 30% percentage improvement in study groups, 10% drop-out).</p><p><strong>Results: </strong>Intention-to-treat analysis showed significant improvement in VASI (Friedman's analysis of variance, <i>P</i> < 0.01) in group A (1048.00 ± 1450.10 reduced to 933.43 ± 1387.79) and group B (415.00 ± 458.47 reduced to 283.85 ± 386.61) at the end-of-treatment visit (24^th week). Improvement was noted from 12 weeks onwards in group A and eight weeks onwards in group B (post-hoc Dunn's test, <i>P</i> < 0.001). Within group comparison showed significantly more improvement in group B than group A from eight weeks onwards (<i>P</i> < 0.05, analysis of covariance test with baseline VASI as covariate). A similar result was obtained with VIDA. DLQI significantly improved only in group B. The monthly cost of travel and loss of time were significantly less (Mann-Whitney's test, <i>P</i> < 0.5) in group B than group A. No adverse events were noted in either group.</p><p><strong>Conclusion: </strong>Both NBUVB and hydroxychloroquine combined with topical clobetasol are safe and effective agents in the treatment of vitiligo, though the improvement is more and faster with hydroxychloroquine. With hydroxychloroquine, there is no infrastructural requirement, less travel cost and less loss of working hours as opposed to NBUVB, which needs infrastructural set-up.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"70 2","pages":"115"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypo-pigmented Lesions - Not as Innocuous as They Look.","authors":"Surjyamukhi Bhattacharyya, Aparajita Ghosh, Sambit Chatterjee","doi":"10.4103/ijd.ijd_1110_23","DOIUrl":"10.4103/ijd.ijd_1110_23","url":null,"abstract":"","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"70 2","pages":"115"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insight into Paediatric Versus Adult Leprosy: A Comparative, Analytical Study from India.","authors":"Deepika Pandhi, Pratibha Gupta, Archana Singal, Vijay Gandhi, Chander Grover, Rajeev Kumar","doi":"10.4103/ijd.ijd_414_24","DOIUrl":"10.4103/ijd.ijd_414_24","url":null,"abstract":"<p><strong>Background: </strong>Pediatric leprosy, though relatively less common compared to adult cases, presents challenges in diagnosis, treatment, and management. Despite global efforts to eradicate leprosy, it remains endemic in certain regions, particularly low-resource settings.</p><p><strong>Objectives: </strong>To analyse differences in clinical presentation of pediatric leprosy as compared to adult leprosy from leprosy clinic records of a tertiary care hospital and outline the clinical implications.</p><p><strong>Methods: </strong>A retrospective analysis of the records of all the registered paediatric (aged ≤ 18 years) and adult cases of leprosy from January 2010 to December 2021 (12-year period) who presented to the leprosy clinic of Guru Teg Bahadur Hospital in Delhi was carried out. History, examination, and investigation parameters were noted from standardised case record forms. The variables were compared between cases of childhood and adult leprosy.</p><p><strong>Results: </strong>Out of total 1006 recorded cases of leprosy, 16.8% were children and 83.2% were adults. Maximum cases (65.7%) were of borderline tuberculoid (BT) leprosy in children compared to 41.7% BT cases in adults. Type 1 and type 2 leprosy reactions were seen in 11.2% and 7.1% paediatric cases, respectively, compared to 9.8% and 12.3% cases in adults, respectively. Paralytic deformity was seen in 32.5% child cases and 35% adult cases. Claw hand and foot drop was seen in 17.2% and 3.6% cases of leprosy in children and 16.1% and 6.5% cases in adults. A total of 11.8% children developed facial palsy. Slit skin smear was positive in 15.4% paediatric and 30.1% adult cases. Treatment was completed in 65.1% child cases and 27.8% children defaulted. In adult cases, treatment was completed in 61.8% cases and 28.9% cases defaulted.</p><p><strong>Conclusion: </strong>Paediatric leprosy in our study had a high number of cases of type 1 lepra reaction, paralytic deformities, disabilities, pure neuritic leprosy, and default rate. Our study highlights the need of early detection, timely intervention, and increasing community awareness to ensure early and adequate management of paediatric leprosy.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"70 2","pages":"75-81"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrichia with Papular Lesions: Dermoscopy to the Rescue.","authors":"Neha Yadav, Molisha Bhandari, Vivek Sharma","doi":"10.4103/ijd.ijd_508_23","DOIUrl":"10.4103/ijd.ijd_508_23","url":null,"abstract":"","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"70 2","pages":"106-107"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 7-Year Retrospective Study of Narrowband Ultraviolet B Phototherapy for Psoriasis in Geriatric Patients.","authors":"Lili Legiawati, Rinadewi Astriningrum, Shannaz N Yusharyahya, Vivianne Chandrakesuma, Andria A Pulungan","doi":"10.4103/ijd.ijd_184_23","DOIUrl":"10.4103/ijd.ijd_184_23","url":null,"abstract":"<p><strong>Background: </strong>Complications of psoriasis may add to the burden of degenerative diseases already present in elderly patients. Phototherapy is a well-established treatment for psoriasis, and narrowband ultraviolet B (NB-UVB) is currently the first-line phototherapy for psoriasis. Its use in elderly has been assessed and is found to be safe and efficacious for many dermatoses.</p><p><strong>Aims and objectives: </strong>To learn the efficacy and safety of NB-UVB phototherapy in geriatric patients with psoriasis in Indonesia.</p><p><strong>Materials and methods: </strong>A retrospective study using data from medical records of psoriasis patients aged ≥60 who received NB-UVB phototherapy at the dermatovenereology outpatient clinic of Dr. Cipto Mangunkusumo National General Hospital in 2014-2020. The data were processed using SPSS version 25, and descriptive analysis was conducted.</p><p><strong>Results: </strong>From 30 patients, 75% reduction of Psoriasis Area and Severity Index was accomplished by 14 patients (47%) after a median of 21 sessions and a median cumulative dose of 25.7 J/cm2. The side effects were experienced by nine patients (30%), comprising pain, burn, and itch. No patient experienced more than two episodes of erythema during their treatment. Most side effects are mild and do not require discontinuation of therapy.</p><p><strong>Conclusions: </strong>NB-UVB phototherapy is safe and effective for geriatric patients with psoriasis.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"70 2","pages":"53-56"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Registering Copyright for Intellectual Property in India: A Technical Guide.","authors":"Himel Mondal, Shaikat Mondal","doi":"10.4103/ijd.ijd_158_24","DOIUrl":"10.4103/ijd.ijd_158_24","url":null,"abstract":"","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"70 2","pages":"110-111"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paradoxical Behçet's Disease after Ixekizumab: A Case Report and Literature Review.","authors":"Yue-Kang Ren, Ling Ren, Wen Sun, Hong-Ye Liu, Shu-Ping Guo","doi":"10.4103/ijd.ijd_719_24","DOIUrl":"10.4103/ijd.ijd_719_24","url":null,"abstract":"<p><p>Behçet's disease is a chronic inflammatory condition that affects multiple organs and systems. It is characterized by recurrent oral and genital ulcers. A previous study reported that the IL-17A inhibitor secukinumab can improve the skin and mucosal manifestations in patients with refractory Behçet's disease. Additionally, secukinumab has been shown to effectively improve neurological symptoms when administered for Behçet's disease. However, we report a case where Behçet's disease occurred after the treatment of psoriasis with the IL-17A inhibitor ixekizumab. To summarize its clinical characteristics and treatment experience, we consulted relevant domestic and international literature and conducted a literature review. We concluded that anti-IL-17A treatment may lead to the development of Behçet's disease. The reported cases are more likely to occur in middle-aged men with varying onset times. The main manifestations include oral and vulvar mucosal ulcers. Furthermore, the gut microbiota may be involved in paradoxical Behçet's disease.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"70 1","pages":"42-46"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychotropic Drugs in Dermatology Part 1: Anti-depressants and Mood Stabilisers.","authors":"Varsha L Kenkare, Bhushan Madke, Ankita Choudhary, Shiti Bose","doi":"10.4103/ijd.ijd_792_23","DOIUrl":"10.4103/ijd.ijd_792_23","url":null,"abstract":"<p><p>Psycho-dermatology is an evolving speciality of psychosomatic medicine where psychological factors play a role in initiating and/or exacerbating the dermatological conditions. Dermatologists should be well versed with the basic pharmacotherapy of psycho-cutaneous disorders and work in close liaison with the psychiatrists when it comes to the holistic management of the same. The review has been divided into two parts, with part 1 consisting of anti-depressants and mood stabilisers and part 2 consisting of anti-psychotics, anxiolytics, and sedative-hypnotic agents used in psycho-dermatology. This comprehensive review focusses on the various psychotropic drugs which are of paramount significance to the dermatologists. The knowledge of these drugs will lead to the pertinent treatment of the psychiatric dermatoses, which has been a less explored territory in the arena of dermatology. Within the realm of psycho-dermatology, a diverse array of anti-depressants is utilised to address psychiatric dermatoses. These include selective serotonin reuptake inhibitors like citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline, alongside selective serotonin norepinephrine reuptake inhibitors such as venlafaxine, desvenlafaxine, and duloxetine. Additionally, norepinephrine dopamine reuptake inhibitors like bupropion; tricyclic antidepressants including doxepin, amitriptyline, imipramine, and clomipramine; and tetracyclic antidepressants like mirtazapine are commonly employed. Supplementary medications like anti-convulsants (e.g., gabapentin and pregabalin) further enrich the therapeutic landscape in psycho-dermatology. The approach to treatment in psycho-dermatology is meticulous, starting with a precise psychiatric diagnosis and followed by tailored drug interventions. Factors such as individual response, side-effect profiles, potential drug interactions, and concurrent medical conditions guide the selection and titration of medications. Typically, treatment initiates at conservative doses, with adjustments made based on patient progress and tolerability. This comprehensive review not only illuminates the psycho-cutaneous indications of these medications including in patients with co-morbidties but also underscores the imperative of vigilant monitoring for adverse effects and its management. This systematic review aimed to evaluate the use of psychotropic medications, including antidepressants and mood stabilizers, in dermatology. A comprehensive search of PubMed Central was conducted for studies published between 1986 and 2023, focusing on meta-analyses, reviews, and systematic reviews. After screening 2287 records, 26 studies met the inclusion criteria. The findings underscore the potential role of psychotropic drugs in managing dermatological conditions, highlighting the need for further research to strengthen the evidence base in psycho-dermatology.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"70 1","pages":"23-37"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinico-Epidemiological Study of Morphological Patterns of Allergic Contact Dermatitis due to Lac Bangles in Females of Hadoti Region.","authors":"Neha Sharma, Ramesh Kumar, Devendra Yadav, Asha Nyati, Suresh Kumar Jain, Apoorva Panwar","doi":"10.4103/ijd.ijd_314_24","DOIUrl":"10.4103/ijd.ijd_314_24","url":null,"abstract":"<p><strong>Background: </strong>India is a country with diverse religious and cultural practices instigating skin diseases which may be missed due to lack of awareness. Contact dermatitis (CD) to lac is not uncommon yet an underreported entity.</p><p><strong>Objectives: </strong>To study clinical patterns of allergic CD due to lac bangles and to assess common contact allergens.</p><p><strong>Methodology: </strong>A retrospective study was conducted after approval by an ethical committee. Out of 850 patients attending the CD clinic from January 2021 to December 2022, the prevalence of CD lac bangles was 40 (4.7%). After obtaining consent, the history of sites, duration, morphology, and DLQI were recorded from patients' medical records. Patch testing with Indian standard series (ISS) and raw lac powder mixed with control was done.</p><p><strong>Results: </strong>A total of 40 females were evaluated. The mean duration between contact and first symptom was 14.8 ± 10.43 months. Morphology was dry eczematous in 18 (45%), lichenoid in 10 (25%), oozy eczematous in 5 (12.5%), urticarial in 5 (12.5%) and vesiculobullous in 2 (5%) patients. In 14 (35%) females, lesions were disseminated. In 12 (30%) females, CD to bindi (4), lipstick (1), Sindhoor (5), rings (1), and plastic slippers (1) were associated. The mean DLQI was 19.37 ± 3.4. Patch test results were positive with ISS allergen epoxy in 9 (22.5%) patients, nickel in 6 (15%), cobalt in 6 (15%), paraphenylenediamine in 5 (12.5%), and lac in only 2 (5%) patients.</p><p><strong>Conclusion: </strong>Data observed in the present study suggests that CD to lac is a distinct clinical entity. Low positivity with lac in patch test proposes the need for standardized testing material.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"70 1","pages":"18-22"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relevance of Atopic Dermatitis Diagnostic Criteria in Context to Indian Paediatric Population: A Cross-sectional Study.","authors":"Meghana Reddy, Namrata Chhabra, Anil Kumar Goel, Satyaki Ganguly","doi":"10.4103/ijd.ijd_491_24","DOIUrl":"10.4103/ijd.ijd_491_24","url":null,"abstract":"","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"70 1","pages":"50"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}