Indian Dermatology Online Journal最新文献

Introduction: Dermoscopy of mucosa is known as mucoscopy. Mucoscopy can aid in delineating minute aspects of mucosal lesions and will guide in the differentiation of similar-looking lesions. To date, there are only a few studies on mucoscopy of genital dermatoses especially from India.

Aim and objectives: The study aims to describe mucoscopic features and correlate histopathologically in various genital mucosal diseases.

Materials and methods: The study was conducted in a tertiary care center in Central India after IHEC approval between October 2020 and April 2022, and the sampling technique was based on a convenience purposive method. Any genital mucosal diseases were included in patients above 18 years of age. Sexually transmitted diseases in general were excluded, however, warts and molluscum contagiosum were included. All patients fulfilling the inclusion criteria were examined after proper informed consent, and the clinical images were photographed using iPhone 11. Dermoscopic images were taken using a DermLite DL4 dermoscope in polarized mode at 10X magnification.

Results: A total of 206 patients were recruited, and mucoscopy features were analyzed. Dermoscopic findings of physiological conditions such as vestibular papillomatosis, pearly penile papules, and Fordyce spots were evaluated. Inflammatory conditions such as lichen planus, pemphigus, and psoriasis were analyzed. Mucoscopy of lichen sclerosus showed white structureless areas (100%), follicular plugs (35%), as well as dotted and linear vessels (80%). Circinate balanitis revealed regular red dotted vessels (100%), coalescing pustules in annular and polycyclic patterns (90%). Squamous cell carcinoma of the penis showed ulceration, serpentine, looped vessels, white structureless area, and yellow-brown crust in a pink background.

Limitations: In our study, because of the inclusion of various diseases, sample size was inadequate, biopsies were not performed in all cases, and variations in mucoscopic features in patients who are already on therapy could not be assessed. Haziness while capturing pictures because of mist formation was hindering the quality of pictures. As patients with premalignant and malignant cases were less, the predicting features for malignant transformation or pathognomoniic signs could not be assessed.

Conclusion: Various dermoscopies have been studied extensively, but the mucoscopy is still a gray area. The results of this study revealed the dermoscopic features of various genital disorders and histopathological correlation in few cases. However, biopsy was not performed in all mucosal disorders; hence, conclusive correlation could not be extrapolated.

Background: Post-acne scarring causes severe physical and psychological distress. Multiple treatment modalities are available with no single gold standard treatment.

Aim and objectives: To assess and compare the efficacy and safety of fractional CO2 laser and microneedling in atrophic acne scars and corelate with variables like scar type, duration, and Fitzpatrick skin types.

Materials and methods: Thirty patients (aged 20-40 years) with facial post-acne atrophic scars with the same Goodman and Baron (GB) grade on both sides of the face were included in the study after written informed consent. After priming skin, four monthly sessions of fractional CO2 laser on the right and microneedling on the left side were performed with 2 months follow-up.

Results: GB (3.53 to 2.37) grade and patient's subjective score (8.63 to 4.37) showed 32.9% and 49.4% improvement over the fractional CO2 laser side and 9.3% (3.53 to 3.20) and 19.7% (8.63 to 6.93) improvement over the microneedling side, respectively, and the difference between the two modalities being statistically significant. Rolling (42.90% vs. 16.18%) and boxcars (36.18% vs. 3.74%) also showed more improvement with fractional CO2 laser. Ice-pick scars responded the least with both modalities. Scars of less than 10 years duration responded better to both modalities with sustained improvement during the study. However, postinflammatory hyperpigmentation (30% vs. 6.67%) was greater with fractional CO2 laser (more in higher Fitzpatrick skin types).

Limitations: Small sample size, short follow-up period, and subjective assessment methods.

Conclusion: Both microneedling and fractional CO2 laser improve the overall appearance of atrophic post-acne scars. The latter was more effective than the former but with a slightly longer healing time and greater post-procedure hyperpigmentation.

Abrocitinib is a novel oral small molecule which acts as a selective JAK-1 inhibitor. Currently approved for use in moderate-to-severe cases of atopic dermatitis, this drug is gaining a rapid impetus for its use across various inflammatory dermatoses for its selective downstream action on cytokines of the JAK-1 pathway. Its efficacy and safety in atopic dermatitis has been established in phase 3 clinical trials. The future implication of this drug will depend largely on feasibility and practical use in Indian scenario.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disorder affecting pilosebaceous units causing painful nodules, abscesses, and scarring. Despite global studies linking HS to metabolic syndrome, insights specific to Indian patients are limited.

Materials and methods: This study aimed to describe the clinicodemographic characteristics and study frequency of metabolic syndrome in Indian HS patients. In this cross-sectional study, 100 HS patients were evaluated for clinical characteristics, comorbidities, pain and suppuration scores, quality of life, and ophthalmological and dental abnormalities. Metabolic parameters, including anthropometry and blood markers, were performed in all cases and 100 age- and gender-matched controls.

Results: The mean age was 29.47 years, with a male predominance of 57%. HS predominantly affected a combination of two or more sites (60%), with nodules as primary lesions (95%). Quality of life was significantly impaired, with 49% experiencing moderate impact as per Dermatology Life Quality Index. Metabolic derangements, represented by an increased body mass index, waist circumference, blood pressure, fasting blood sugar, and fasting insulin, were significantly more frequent in HS cases compared to controls (P < 0.001). The frequency of metabolic syndrome in HS patients was 42%, significantly higher than controls (8%, P < 0.001) with a relative risk of 5.25 (95% CI 2.68-10.58). Dental and ophthalmological abnormalities were observed in 35% and 21.7% of screened patients, respectively.

Limitations: Cross-sectional nature, no prospective assessment to determine evolution with time, and limited patient number are the limitations of the study.

Conclusion: A substantial association with metabolic syndrome and considerable impact on quality of life is seen in Indian HS patients, emphasizing the need for metabolic screening and holistic management strategies.