Indian Dermatology Online Journal最新文献

Background: Syphilis is a bacterial infection caused by Treponema pallidum . In recent years, there has been a rising trend of syphilis noted worldwide, including in India. The aim of this study was to analyze the changing epidemiological patterns, demographic attributes, high-risk behavior, clinical presentations, and stages of syphilis among patients attending the sexually transmitted infections (STI) clinic at a tertiary healthcare facility in eastern Uttar Pradesh over the last 7 years.

Patients and methods: We conducted a retrospective study spanning 7 years (2017-2023) at a tertiary care center. Demographics and clinical data of all confirmed cases were recorded and analyzed.

Results: Over 7 years, 8,325 patients who attended the STI clinic were included in this study. Among STI clinic attendees, 2.78% tested positive for syphilis, confirmed by either a positive venereal disease research laboratory (VDRL) test along with a positive Treponema pallidum hemagglutination assay (TPHA) test or by TPHA positivity alone, with males representing the majority at 87%. The mean age of patients was 34.80 ± 8.01 years, with most patients falling into the 25-34 years age group. The prevalence of syphilis among STI clinic attendees showed a rising trend from 1.55% in 2017 to 4.05% in 2023, which was statistically significant. High-risk behaviors such as multiple sexual partners (62%) and contact with commercial sex workers (35%) were frequently reported. In our study, 73% of patients were diagnosed in the late latent stage of syphilis, whereas 13% were in the secondary stage, 9% in the early latent phase, and 5% in the primary stage. Additionally, concurrent STIs were observed in 24% of syphilis-positive patients, with genital warts being the most common.

Limitations: The retrospective nature of the study, and this being a single-center study, are the major limitations of this study.

Conclusion: This study shows that syphilis is becoming more common. Risky behaviors, such as engaging in sex with multiple partners or with sex workers, were identified as major contributing factors. There is a need for enhanced educational campaigns on safe sex practices.

Background: Alopecia areata (AA) is an unpredictable disease that manifests as rapid and patchy hair loss and may involve any hair-bearing part of the body. We used dermoscopy to compare the dermoscopic findings of AA in patients with and without poor prognostic indicators.

Aims and objectives: To compare the key variations in dermoscopic features between patients of AA with and without poor prognostic indicators.

Patients and methods: This was a retrospective study carried out at a tertiary care teaching hospital in eastern Odisha. The study included the patients of scalp AA from October 2023 to October 2024. A total of 85 patients of AA were evaluated using the Severity of Alopecia Tool (SALT) score and Dermlite DL3 attached to iPhone 12.

Results: A total of 85 patients with AA were included in our study (male: female ratio ~ 2:1). The mean (± standard deviation) age of patients was 26.61 ± 9.82 years. The mean duration of the disease was 5.98 ± 11.74 months. Patchy AA was the most common. The most common dermoscopic feature observed was yellow dots (83.5%), followed by broken hairs (65.9%), black dots (51.8%), vellus hairs (51.8%), tapering hairs (50.6%), and coudability hairs (22.4%). Patients with poor prognostic markers had a substantially higher SALT score (34.99 ± 37.21) compared to those without (10.75 ± 14.08), with P = 0.002. A statistically significant high SALT score was recorded in patients with disease duration >3 months. The dermoscopic features that were significantly more frequent in patients having poor prognostic factors were yellow dots ( P = 0.000), black dots ( P = 0.02), broken hairs ( P = 0.03), and coudability hairs ( P = 0.000), while in patients without poor prognosis, vellus hairs ( P = 0.005) were more commonly seen. The finding of tapering hair ( P = 0.1) was not found to be significantly associated with either group.

Limitations: Retrospective nature of the study and not assessing dermoscopic response to treatment.

Conclusion: Ours is the first study to emphasize the comparison of dermoscopic features of AA in patients with and without poor prognostic indicators. Yellow dots, black dots, broken hairs, and coudability hairs were associated with adverse prognosis, while vellus hair indicated a favorable outcome. Identifying these key dermoscopic markers can help to assess the disease severity, potentially refine prognostic assessments, and guide treatment decisions.

Background: Facial dyschromias (FD) are common among individuals with skin of color. At present, information on the pattern and dermoscopic features of various FD is scarce from South India.

Objective: To describe the clinical and dermoscopic features of FD in patients presenting to a tertiary healthcare center in South India.

Patients and methods: Clinical and dermoscopic examination was performed in 274 patients presenting with FD in the outpatient department of a tertiary healthcare center in South India.

Results: Disorders of facial hyperpigmentation (90.87%) were more commonly encountered than facial hypopigmentation (7.66%); four patients presented with both hyperpigmentation and hypopigmentation (1.46%). Females (76.27%) were more commonly affected than males (23.72%), and most of the patients belonged to the young to middle-aged groups. The common causes of facial hyperpigmentation include melasma, lichen planus pigmentosus, facial acanthosis nigricans, maturational dyschromia, and post-inflammatory hyperpigmentation. The common causes of facial hypopigmentation include tinea versicolor, seborrheic dermatitis, vitiligo, salt and pepper pigmentation, and nevus depigmentosus. Each of these conditions had distinct dermoscopic features, which aided in the diagnosis.

Limitations: Histopathological examination was done in a limited number of cases, being a cross-sectional study, and no follow-up was conducted to observe the evolution of facial pigmentation.

Conclusion: Nearly 90% of FD are hyperpigmentary in nature. The common causes of facial hyperpigmentation include melasma, lichen planus pigmentosus, facial acanthosis nigricans, maturational dyschromia, and post-inflammatory hyperpigmentation. In contrast, tinea versicolor, seborrheic dermatitis, and vitiligo are three common causes of hypopigmentation of the face.