Indian Dermatology Online Journal最新文献

Introduction: Acquired inflammatory Blaschko-linear dermatoses have not been studied extensively. Descriptive studies on segmental vitiligo have yielded insights helpful in counseling patients. Similar insights are expected from studies on other acquired inflammatory Blaschko-linear diseases.

Materials and methods: Consecutive patients with an acquired inflammatory Blaschko-linear disease presenting to the dermatology outpatient department of the study center were recruited in a case series. Detailed history and examination, clinical photographs, and histopathological findings were recorded and analyzed. Features were compared between linear and generalized forms to look for any differences.

Results: Out of 99 patients, linear lichen planus (n = 47), linear morphea (n = 31), and lichen striatus (n = 9) were observed most commonly. Skin lesions were present in multiple lines in 52 (52.5%). In 12 (12.1%), more than one anatomical site was involved. In 10 (10.1%), two different Blaschko-linear diseases were seen, and in 3 (3.1%) both diseases occurred in the same/adjacent segments. The disease extended from one or both ends in 64 (88.9%). Nineteen (19.2%) had both linear and generalized disease, with linear lesions being more severe than the generalized lesions (P = 0.038133). Some (18/47, 38.3%) linear lichen planus cases showed prominent atrophy since the onset and formed a distinct subset, predominantly over the head and neck site (P < 0.00001). Histopathology of linear lichen planus differed from controls with generalized lesions in terms of having deeper infiltrate (P = 0.000124), and multi-focal, rather than confluent, lichenoid infiltrates. Atrophy was noted from the onset in 13/31 (41.9%) cases of linear morphea.

Limitations: Limitations include cross-sectional design and lack of controls with generalized nonlinear diseases.

Conclusions: Acquired inflammatory Blaschko-linear disorders show distinct characteristics like involvement of multiple lines and sites, directional progression, and atrophic variants. These can be used for differentiating among different Blaschko-linear diseases, monitoring progression, and counseling patients.

Background: Dermatosis papulosa nigra (DPN) presents as benign skin growths, predominantly affecting women and often commencing during adolescence. Treatment is sought due to its cosmetic impact, with available modalities often posing risks of scarring and pigmentary changes.

Materials & methods: This study investigates the efficacy of ionized plasma jet therapy (IPJT) in ten DPN patients at a tertiary care hospital in central India. Patients underwent IPJT sessions, along with serial evaluations assessing pain, erythema, pigmentary changes, and lesion clearance.

Results: Results showed 80% lesion clearance after the first session, with mild adverse effects such as erythema (40%), post inflammatory hyperpigmentation (20%), and hypopigmentation (10%) after 4 weeks.

Conclusion: IPJT, utilizing ionized plasma, has shown success in various dermatological applications. The study underscores IPJT as a suitable treatment modality.

Background: Nail aesthetic procedures so far have been a neglected domain of nail medicine. With changing times, more people are getting sensitized towards nail enhancement; hence, there is an ever-increasing need for dermatologist driven aesthetic nail procedures.

Discussion: The management of various nail disorders takes a long time and might not be very rewarding with regard to complete aesthetic improvement. The aesthetic procedures can be utilized to camouflage and provide some relief to the patient. These procedures could also be a treatment modality for various common conditions like brittle nails, onychotillomania, and other habit tic deformities. The aesthetic procedures that we discussed in this article include nail peels, gel nails, and lasers for aesthetic indications. Many side effects of these procedures have been reported in the literature. This can be attributed to the fact that these procedures are currently being done at salons and not by dermatologists.

Conclusion: Nail peels are a useful modality for nail surface irregularities and can be safely recommended. Gel nail technique is simple and when done by a trained person can be used to benefit patients with superficial nail plate abnormalities to improve their quality of life. The usage of lasers in the aesthetic improvement of nails is still in a nascent stage.

Introduction: Nail psoriasis is a relatively unexplored clinical feature in the Indian population. Its correlation with cutaneous, musculoskeletal, and serological manifestations was analyzed.

Material and methods: This study included 45 patients with clinically evident nail psoriasis. Clinical characteristics, Psoriasis Area and Severity Index (PASI), Nail Psoriasis Severity Index (NAPSI), Nail Psoriasis Quality of Life Index 10 (NPQ10) scores and serological markers, Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), and Rheumatoid Arthritis factor (RA factor) were documented, calculated, and assessed to study their correlation.

Results: Mean age was 35.36 ± 13.26 years. Mean NAPSI and NPQ10 were 41.96 ± 29.38 and 5.44 ± 5.31, respectively. Common nail findings were onycholysis (80%), subungual hyperkeratosis (75.5%), and pitting (62.2%). Joint involvement was seen in 31.11% of patients. Positive associations of NAPSI with duration of illness (P < 0.001, β = 0.57) and PASI scores (P < 0.001, β = 0.56) were observed. NPQ10 demonstrated associations with NAPSI (P < 0.001, β = 0.83) and PASI (P = 0.001, β = 0.83). Elevated ESR and CRP levels were associated with higher NAPSI scores (P < 0.001, β = 0.55, and P = 0.003, β = 0.43, respectively). Furthermore, duration of illness, NAPSI, and NPQ10 scores were positively correlated with joint involvement (P < 0.05).

Conclusion: A strong correlation between nail psoriasis severity, disease duration, skin involvement, and nail-specific quality of life was observed. Furthermore, severe nail psoriasis was linked to a higher likelihood of joint involvement and elevated serological markers. These findings emphasize the importance of integrated treatment strategies for affected patients.

Background: Artificial intelligence (AI) is revolutionizing healthcare by enabling systems to perform tasks traditionally requiring human intelligence. In healthcare, AI encompasses various subfields, including machine learning, deep learning, natural language processing, and expert systems. In the specific domain of onychology, AI presents a promising avenue for diagnosing nail disorders, analyzing intricate patterns, and improving diagnostic accuracy. This review provides a comprehensive overview of the current applications of AI in onychology, focusing on its role in diagnosing onychomycosis, subungual melanoma, nail psoriasis, nail fold capillaroscopy, and nail involvement in systemic diseases.

Materials and methods: A literature review on AI in nail disorders was conducted via PubMed and Google Scholar, yielding relevant studies. AI algorithms, particularly deep convolutional neural networks (CNNs), have demonstrated high sensitivity and specificity in interpreting nail images, aiding differential diagnosis as well as enhancing the efficiency of diagnostic processes in a busy clinical setting. In studies evaluating onychomycosis, AI has shown the ability to distinguish between normal nails, fungal infections, and other differentials, including nail psoriasis, with a high accuracy. AI systems have proven effective in identifying subungual melanoma. For nail psoriasis, AI has been used to automate the scoring of disease severity, reducing the time and effort required. AI applications in nail fold capillaroscopy have aided the analysis of diagnosis and prognosis of connective tissue diseases. AI applications have also been extended to recognize nail manifestations of systemic diseases, by analyzing changes in nail morphology and coloration. AI also facilitates the management of nail disorders by offering tools for personalized treatment planning, remote care, treatment monitoring, and patient education.

Conclusion: Despite these advancements, challenges such as data scarcity, image heterogeneity, interpretability issues, regulatory compliance, and poor workflow integration hinder the seamless adoption of AI in onychology practice. Ongoing research and collaboration between AI developers and nail experts is crucial to realize the full potential of AI in improving patient outcomes in onychology.