Indian Journal of Dermatology最新文献

{"title":"Efficacy and Safety Profile of Oral Tofacitinib in Non-Segmental Vitiligo.","authors":"Soumya Jagadeesan, Neenu Prasad, Prasanna Duraiswamy, Vinitha Varghese Panicker","doi":"10.4103/ijd.ijd_141_25","DOIUrl":"10.4103/ijd.ijd_141_25","url":null,"abstract":"<p><strong>Background: </strong>Vitiligo is a chronic disease that is often challenging to treat. Melanocyte destruction in vitiligo is mediated by immune pathways involving IFN-γ and CD8+ T cells. Tofacitinib, a Janus kinase (JAK) 1/3 inhibitor, can be a promising treatment for vitiligo due to its potential to inhibit IFN-γ signaling. We retrospectively reviewed the records of 16 patients (6 men, 10 women; mean age 39.7 years) with nonsegmental vitiligo refractory to conventional therapies who were treated with oral tofacitinib along with topical tacrolimus and phototherapy.</p><p><strong>Aims: </strong>To evaluate the efficacy and adverse effects of the JAK1/3 inhibitor, oral tofacitinib, in the treatment of nonsegmental vitiligo.</p><p><strong>Methods: </strong>We retrospectively reviewed the records of 16 patients (6 men, 10 women; mean age: 39.7 years) with nonsegmental vitiligo refractory to conventional therapies who were treated with oral tofacitinib along with topical tacrolimus and phototherapy. Improvement was assessed using Vitiligo Area Scoring Index (VASI) at weeks 6, 12, and 24. Hemogram, lipid profile, liver, and renal function tests were monitored during the treatment period.</p><p><strong>Results: </strong>Improvement was assessed using Vitiligo Area Scoring Index (VASI) at weeks 6, 12, and 24. Mean VASI scores improved from 5.038 at baseline to 1.269 at 24 weeks, with 13 patients (81.25%) achieving at least 50% improvement. Transient leukopenia was observed in 3 patients, and one patient developed palmar warts.</p><p><strong>Conclusions: </strong>Oral tofacitinib shows significant potential in the management of nonsegmental vitiligo, in patients unresponsive to conventional therapies especially in combination with phototherapy. No significant adverse effects were observed during the follow up period other than a transient leukopenia in three patients and palmar warts in one patient.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"71 3","pages":"196-198"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868157","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":"Skin Allergy Research Society and Society for Eczema Studies Joint Task Force Guidelines of Care for Management of Atopic Dermatitis for Adults, Children, and Special Populations in India: An Evidence-Based Review and an Expert Consensus.","authors":"Sandipan Dhar, Abhishek De, Murlidhar Rajgopalan, Kiran Godse, Anant Patil, Disha Chakraborty, Deepika Pandhi, Vijay Zawar, Indrashis Podder, Manas Chatterjee, Aarti Sarda, Anupam Das, Mukesh Girdhar, Dipankar De, Bela Shah, Maitreyee Panda, Nidhi Sharma, Soumya Jagadeesan, D S Krupa Shankar, Abhijit Saha, Raghubir Banerjee, Rajib Malakar, Saumya Panda","doi":"10.4103/ijd.ijd_421_25","DOIUrl":"10.4103/ijd.ijd_421_25","url":null,"abstract":"<p><p>Atopic dermatitis (AD) is a chronic inflammatory skin disease with significant morbidity. Recognising the need for region-specific guidance, the Skin Allergy Research Society and Society for Eczema Studies have collaborated to develop updated, evidence-based guidelines tailored to the Indian context. These guidelines address AD management across all age groups, special populations while considering local epidemiology, healthcare infrastructure, and treatment accessibility. A structured Delphi consensus process was conducted among 23 dermatology experts over 3 months through virtual and in-person meetings. Literature from MEDLINE, Cochrane, and Google Scholar was systematically reviewed, and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach was used to assess evidence quality. Clinical recommendations were refined through multiple voting rounds, leading to consensus statements. Recommendations are based on an extensive literature review up to December 2024. This document updates the 2019 Skin Allergy Society guidelines, reinforcing global recommendations while allowing local adaptability. These guidelines provide updated recommendations for topical, systemic, phototherapy, and biologic therapies in AD. Key advancements include the introduction of topical crisaborole and JAK inhibitors for mild to moderate AD, along with a focus on emerging systemic therapies, such as biologics and systemic JAK inhibitors. In the Indian context, the guidelines define the roles of dupilumab and abrocitinib while also addressing the off-label use of tofacitinib and baricitinib in resource-limited settings. Specific recommendations are provided for children, elderly patients, and pregnant women, emphasising safety considerations for systemic and biologic therapies. These guidelines align with global AD management while incorporating India-specific adaptations based on epidemiology, accessibility, and affordability. They serve as a key reference for dermatologists, pediatricians, and general practitioners in India and other resource-limited settings. Though tailored for India, they are also relevant to dermatologists in developing countries, guiding treatment selection based on disease patterns, environmental factors, and medication availability.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"71 3","pages":"204-230"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868238","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":"Evaluation of Outcomes of Dupilumab Therapy in Patients with Atopic Dermatitis - A Single-Center Retrospective Longitudinal Study.","authors":"Andrea Miniello, Francesco Pugliese, Ilaria Pepe, Giovanna Pastore, Maria Lassandro, Chiara Calabrese, Eustachio Nettis","doi":"10.4103/ijd.ijd_25_24","DOIUrl":"10.4103/ijd.ijd_25_24","url":null,"abstract":"<p><strong>Background: </strong>Eczema control is a measurable construct currently recommended to be monitored for the management of atopic dermatitis (AD) in clinical trials.</p><p><strong>Aims: </strong>Measuring eczema-related outcomes with a focus on patient-perceived eczema control in AD patients over a period of 12 months during which they were treated with dupilumab.</p><p><strong>Methods: </strong>All patients with severe AD (Eczema Area and Severity Index (EASI) score ≥24) who initiated dupilumab from June 2020 to February 2022 and continued treatment for at least one year were included in this study. Monitored outcomes include EASI, Atopic Dermatitis Control Tool (ADCT), Dermatology Life Quality Index (DLQI) and peak pruritus/sleep Numerical Rating Scale (NRS).</p><p><strong>Results: </strong>Sixty-one patients were included. At 4 months of treatment, absolute cutoff score EASI ≤7 was reached by 59% of patients, ADCT ≤7 by 50.8%, DLQI ≤5 by 78.7%, itch-NRS ≤4 by 68.8% and sleep NRS ≤4 by 8.5%. At 12 months of treatment, absolute cutoff score EASI ≤7 was reached by 85.2%, ADCT ≤7 by 83.6%, DLQI ≤5 by 86.9%, itch-NRS ≤4 by 88.5% and sleep NRS ≤4 by 91.8%. Minimally clinically important difference of ≥5 ADCT points and ≥4 DLQI points were achieved, respectively, by 96.7% and 88.5% of patients at 4 months and by 100% and 96.7% at 12 months.</p><p><strong>Conclusions: </strong>This study found that treatment with dupilumab consistently achieved disease control at 12 months of therapy. At 4 months, statistically meaningful improvements relative to baseline were observed for all the patient-related outcomes even though only half of our cohort reached the treat-to-target cutoffs for EASI and ADCT.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"71 3","pages":"185-190"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868235","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":"Bedside Monitoring of Mycetoma: A Neglected Undertaking in a Neglected Tropical Disease.","authors":"Sonika Garg, Shreya K Gowda, Arpita Nibedita Rout, Chandra Sekhar Sirka, Victor Semy","doi":"10.4103/ijd.ijd_939_24","DOIUrl":"10.4103/ijd.ijd_939_24","url":null,"abstract":"<p><p>Mycetoma is a prevalent yet neglected tropical disease, particularly in eastern India, where its diagnosis remains challenging due to the low sensitivity of histopathology and culture tests. This manuscript highlights bedside monitoring techniques that aid in assessing therapeutic response, including lesion mapping, girth measurement, sinus count, grain assessment, range of motion evaluation, modified visual analogue scale, and patient-reported outcomes. These methods provide valuable insights for clinicians managing mycetoma, facilitating early detection of treatment response and improving patient care.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"71 2","pages":"142-144"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511784","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":"Combination Therapy with Oral Doxycycline and Intradermal Botulinum Toxin Type A for Moderate-to-Severe Rosacea: A Randomized Controlled Trial.","authors":"Tuyen T Nguyen, Doanh H Le, Ha T Vu, Luong H Vu, Minh N Vu, Phuong T M Pham","doi":"10.4103/ijd.ijd_654_24","DOIUrl":"10.4103/ijd.ijd_654_24","url":null,"abstract":"<p><strong>Background: </strong>Rosacea is a chronic inflammatory skin disorder, particularly challenging in moderate-to-severe cases, characterized by symptoms such as facial papules, pustules, erythema, flushing, and telangiectasia, which severely impact quality of life. Although oral doxycycline is a primary treatment, its efficacy against erythema is limited, necessitating the exploration of combination therapies. Intradermal botulinum toxin type A (BTX) has shown promise in managing facial erythema and flushing, but its combined use with doxycycline has not been evaluated.</p><p><strong>Objectives: </strong>This study aims to evaluate the effectiveness and safety of combining oral doxycycline with intradermal BTX (combination therapy) versus doxycycline with normal saline (monotherapy) in treating moderate-to-severe rosacea.</p><p><strong>Methods: </strong>A randomized, controlled trial was conducted with 46 participants aged 18 and older, diagnosed with moderate-to-severe rosacea. Participants were randomized to receive either combination therapy (doxycycline and BTX) or monotherapy (doxycycline and normal saline) for three months. Efficacy was assessed using the Clinician Erythema Assessment (CEA), Global Flushing Severity Score (GFSS), Investigator Global Assessment (IGA), telangiectasia degree, and Dermatology Life Quality Index (DLQI). Safety evaluations included monitoring adverse reactions.</p><p><strong>Results: </strong>Both groups showed significant reductions in CEA scores from baseline, with combination therapy demonstrating greater improvement (<i>P</i> < 0.001). Combination therapy also significantly reduced GFSS and IGA scores compared to monotherapy (<i>P</i> < 0.05). No significant changes were observed in the degree of telangiectasia. DLQI scores improved significantly in both groups, with greater reductions in the combination therapy group (<i>P</i> < 0.05). Common adverse events, including injection site pain, erythema, and oedema, were tolerable and comparable between groups.</p><p><strong>Conclusion: </strong>The combination of oral doxycycline and intradermal BTX is more effective than doxycycline monotherapy in reducing erythema, flushing, and inflammatory lesions in moderate-to-severe rosacea, with a comparable safety profile. This combination therapy offers a promising approach for comprehensive management of rosacea symptoms.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"71 2","pages":"135-141"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511885","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 Cross-Sectional Study on Cosmetovigilance in India: From the Dermatologist's Perspective.","authors":"Manjula Nayak, Virendra S Ligade","doi":"10.4103/ijd.ijd_973_23","DOIUrl":"10.4103/ijd.ijd_973_23","url":null,"abstract":"","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"71 2","pages":"169"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511796","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":"Prevalence of Metabolic Syndrome in Chronic Spontaneous Urticaria and Associated Risk-Factors-An Analytical Cross-Sectional Study.","authors":"Indrashis Podder, Arunima Dhabal, Himel Mondal, Sankha Subhra Chakraborty","doi":"10.4103/ijd.ijd_885_24","DOIUrl":"10.4103/ijd.ijd_885_24","url":null,"abstract":"<p><strong>Background: </strong>Chronic spontaneous urticaria (CSU) is a persistent low-grade inflammatory condition, which may be associated with metabolic syndrome (MetS).</p><p><strong>Objective: </strong>To estimate the prevalence of MetS in CSU patients and identify associated risk factors.</p><p><strong>Methods: </strong>We conducted a cross-sectional study including 74 CSU patients and 58 age-and-sex-matched healthy controls. Disease duration was assessed in all CSU patients along with disease activity and control using the UAS7 and UCT scores respectively. MetS was diagnosed by NCEP-ATP III criteria in all study participants. Additional biochemical parameters included absolute eosinophil and basophil counts. The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV), and serum total IgE, to identify potential risk factors for MetS.</p><p><strong>Results: </strong>CSU patients (mean age 35.4 ± 11.5 years, M: F 36:38) showed a higher prevalence of MetS, vs. healthy controls (mean age 31.9 ± 9.7 years, M: F 20:38), although statistically comparable [cases vs. controls 24.3% vs. 20.7%, <i>P</i> = 0.8]. CSU patients had higher diastolic blood pressure (<i>P</i> = 0.004) and lower HDL level (<i>P</i> = 0.014), (vs. controls). The median (IQR) duration of CSU was 6 (4-12) months and every third patient presented with uncontrolled CSU (UCT <12). There was no significant association between MetS and clinical disease characteristics such as duration, angioedema, symptomatic dermographism, disease severity, and control. However, CSU patients with metabolic syndrome had significantly higher age (<i>P</i> = 0.0002), higher serum total IgE (<i>P</i> = 0.0001), and higher mean platelet volume (<i>P</i> = 0.04), compared to those with normal metabolic status. Multivariate regression analysis revealed higher age (OR 1.2, <i>P</i> = 0.004) and higher fasting blood sugar (OR 1.5, <i>P</i> = 0.03) to be significant risk factors for MetS.</p><p><strong>Conclusion: </strong>MetS is more prevalent in CSU patients compared to healthy controls, although statistically comparable. All CSU patients need screening for underlying MetS, independent of their disease characteristics. Notably, higher age at presentation, higher total serum IgE, higher MPV, and raised FBS may aggravate the risk for MetS.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"71 2","pages":"127-134"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511873","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":"Fatal Colitis Associated with Immune-Related Adverse Events and Immune Reconstitution Inflammatory Syndrome by Cytomegalovirus.","authors":"Yasuaki Ikuno, Toshifumi Takahashi, Satona Rikitake, Yasuhiro Maeda, Takahiro Koike, Akihiko Yamaguchi, Akiko Arakawa, Takayuki Imai, Hiroshi Matsumoto, Noriki Fujimoto","doi":"10.4103/ijd.ijd_783_23","DOIUrl":"10.4103/ijd.ijd_783_23","url":null,"abstract":"","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"71 2","pages":"161-162"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511937","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":"Bowen's Disease of Skin Over Thigh Treated with Electron Beam Radiotherapy- A Case Letter.","authors":"K N Srinivasan, Gowthami Venugopal, Sudha Kaliappan, N Lalitha Rani","doi":"10.4103/ijd.ijd_334_23","DOIUrl":"10.4103/ijd.ijd_334_23","url":null,"abstract":"","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"71 2","pages":"162-164"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511921","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":"Unravelling the Mystery: A Rare Case of a Cutaneous Horn with Dermoid Cyst at the Oral Commissure.","authors":"Palak Borade, Ashok Vikey, Jaya Joshi, Sakshi Arora","doi":"10.4103/ijd.ijd_659_24","DOIUrl":"10.4103/ijd.ijd_659_24","url":null,"abstract":"","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"71 2","pages":"151-152"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511889","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}