{"title":"Comparison of the Efficacy of Intradermal Tranexamic Acid and Topical Triple Combination Modification in Decreasing the Severity Score of Melasma: A Meta-analysis.","authors":"Anindia Indraswari, Diah Mira Indramaya, Maylita Sari, Budi Utomo, Evy Ervianti, Trisniartami Setyaningrum, Astindari Astindari, Menul Ayu Umborowati","doi":"10.4103/ijd.ijd_1002_23","DOIUrl":"10.4103/ijd.ijd_1002_23","url":null,"abstract":"<p><p>Melasma is a symmetrical chronic hypermelanosis that affects the skin of the face, characterised by brownish patches with uneven margins, particularly in areas regularly exposed to sunlight. Although topical triple combination modifications are good first-line therapy for melasma, they have a wide range of negative effects. Consequently, new effective treatments with fewer side effects are required. It has been observed that intradermal tranexamic acid (TA) has low adverse effects and a good therapeutic response in treating melasma. This study aimed to assess the degree of the melasma area and severity index in patients treated with topical triple combination modifications and intradermal tranexamic acid therapy. Electronic databases were searched for relevant articles based on predetermined eligibility requirements. The statistical analysis was conducted using the Review Manager (RevMan) v5.4 software. Randomized controlled trials were used in designing three investigations with a total of 184 patients. After intervention, there was a significant difference in the MASI score between the intradermal tranexamic acid group and the modified topical triple combination group, with a mean difference (MD) of -0.81 (95% CI [-1.05, -0.57]), a combined result of 6.54 with <i>P</i> < 0.00001 and low heterogeneity (I2 = 0%). The intradermal tranexamic acid group also demonstrated a lower MASI score, and the funnel plot revealed no publication bias. This study found that intradermal tranexamic acid is more effective than topical triple combination modifications and has fewer side effects. Therefore, it can serve as an alternative primary therapy option for melasma.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"70 2","pages":"89-96"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752302","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":"Lipid Profile Scores Predict Severity of Pemphigus: A Cross-Sectional Study.","authors":"Maryam Fallah, Anahita Najafi, Mahsa Ranjbar, Kamran Balighi, Maryam Daneshpazhooh, Soraiya Ebrahimpour-Koujan","doi":"10.4103/ijd.ijd_372_24","DOIUrl":"10.4103/ijd.ijd_372_24","url":null,"abstract":"<p><strong>Background: </strong>There is little evidence about the relationship between lipid indices and the severity of pemphigus vulgaris (PV) disease. In this cross-sectional study, we try to find out the exact relationship between three dietary lipid indices (PUFA/SFA ratio and ω-6/ω-3 index) and the severity of PV disease.</p><p><strong>Methods: </strong>In this hospital-based cross-sectional study, a total of 138 pemphigus vulgaris cases were studied, of which 108 had PDAI ≤15, and 30 had PDAI>15. Dietary intakes were measured a valid 168-item FFQ. To calculate the lipid indices, the data received from diet were used.</p><p><strong>Results: </strong>After adjusting for potential confounders, people with the highest ω-6/ω-3 index had 32% lowest severity of PV disease compared to the people in the lowest category. However, this association was not significant in all models (OR: 0.68; 95% CI: 0.24-1.93, <i>P</i> <sub>trend</sub> = 0.47). Moreover, people with the highest PUFA/SFA index had 9% highest severity of PV disease compared to the people in the lowest category. However, this association was not significant in all models (OR: 1.09; 95% CI: 0.34-3.51, <i>P</i> <sub>trend</sub> = 0.88).</p><p><strong>Conclusion: </strong>The evidence of our study shows that the relation between PUFA/SFA ratio and ω-6/ω-3 index is not significant. However, case-control studies are needed to confirm these findings.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"70 2","pages":"63-74"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752416","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}
Shreya K Gowda, Bhini Ameta, Sonika Garg, Biswanath Behera
{"title":"Successful Use of Tofacitinib in Paediatric Prurigo Nodularis: A Report of Four Cases.","authors":"Shreya K Gowda, Bhini Ameta, Sonika Garg, Biswanath Behera","doi":"10.4103/ijd.ijd_842_24","DOIUrl":"10.4103/ijd.ijd_842_24","url":null,"abstract":"","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"70 2","pages":"102-104"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752470","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}
Dhiman Tarafdar, Indrayudh Sen, Sankha Koley, Biswarup Ray, Pinaki Sarkar, Amrita Sil, Arghyaprasun Ghosh, Nilay K Das
{"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<sup>th</sup> 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":"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":"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":"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":"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}