Indian Dermatology Online Journal最新文献

Background: Currently, no treatment can fully and finally treat postherpetic neuralgia (PHN).

Aim and objectives: This study aimed to evaluate the possible efficacy of autologous intralesional platelet-rich plasma (PRP) injection in treating patients with PHN.

Materials and methods: A prospective, single-arm, open-label clinical study was conducted on 45 patients with PHN attending the Dermatology Outpatient Clinics of Sohag University Hospital, Egypt, between November 2019 and November 2021. Patients were subjected to full clinical general and dermatologic examinations. Patient's assessment included severity of pain through visual analogue scale (VAS), numerical rating scale (NRS), and verbal rating scale (VRS), in addition to Medical Outcomes Study 36 Item Short-Form (SF-36). Patients were treated by autologous PRP injection every 2 weeks for 2 months (4 sessions). Patients were evaluated before every session and 3- months after the last session.

Results: There was a significantly decreased VAS, NRS, VRS, and SF-36 questionnaire values in the last session and three months after the last session. There was a highly significant moderate correlation between both scales (VAS and VRS) and patient's age in years and who have aggravating factors. Likewise, there was a significant moderate positive correlation between scales (VAS and VRS) and the disease duration, medical co-morbidities, and associated myalgia.

Limitations: These findings require further confirmations on more inclusive large-sized multicenter, randomized, placebo-controlled, clinical trials with longer follow-up.

Conclusion: This clinical pilot study concluded that autologous intralesional PRP injection was an effective therapeutic option for patients with PHN.

Background: Oral mucosal lesions in pemphigus vulgaris may precede cutaneous lesions and can cause diagnostic confusion. Diagnosis can be made by histopathology, direct immunofluorescence (DIF), and indirect immunofluorescence (IIF). DIF of the oral mucosa is an invasive procedure and difficult to perform in patients with severe mucosal ulcer, and studies have shown that BIOCHIP-IIF can be used to detect desmoglein 1 and 3 in the serum of patients with pemphigus.

Aim: To compare BIOCHIP mosaic-based IIF and oral DIF in patients with oral mucosal pemphigus.

Materials and methods: All cases of oral mucosal pemphigus which were diagnosed by clinical examination and histopathology were included in the study. Oral DIF and BIOCHIP-IIF samples were collected, and the results were analyzed.

Results: Out of 36 patients, DIF was positive in 30 patients (83.3%) and BIOCHIP-IIF in 28 patients (77.8%). On comparing BIOCHIP-IIF with DIF, sensitivity, specificity, positive predictive value, and negative predictive value of BIOCHIP were 80%, 33.3%, 85.71%, and 25%, respectively. Chi-square test showed no statistically significant difference between oral DIF and BIOCHIP-IIF (P value is 0.5143). Among the 28 patients who had positive BIOCHIP, 27 patients (96.4%) showed desmoglein (Dsg) 3 positivity, and 16 patients (57.1%) showed Dsg 1 positivity. The sensitivity and specificity of Dsg1 were 53.3% and 100%, respectively. The sensitivity and specificity of Dsg3 were 76.6% and 33.3%, respectively.

Conclusion: BIOCHIP-IIF can be used as an alternative to oral DIF in the diagnosis of oral mucosal pemphigus.

Nontuberculous mycobacterial (NTM) infections are increasingly recognized, particularly in tropical regions and are often found in immunocompetent individuals. These infections are emerging as significant health concerns, especially pulmonary NTM, which is reported more frequently and is known to be associated with hospital environments. While pulmonary NTM infections are on the rise, partly due to drug resistance and possible patient-to-patient transmission, there is no current evidence indicating an increase in cutaneous NTM infections. The clinical manifestations of NTM infections, except for well-known entities like Buruli ulcer and fish tank granuloma, are diverse and nonspecific, often mimicking other chronic infections. History of minor trauma at the site of infection can be misleading and may complicate the diagnosis of cutaneous NTM. Surgical-site and port-site NTM infections typically present with erythema, edema, and abscesses and are commonly caused by rapidly growing mycobacteria like M. fortuitum and M. chelonae. These infections may not respond to standard antibiotics, suggesting the need for NTM-specific treatment. Diagnostically, histopathology may not be conclusive, and standard staining techniques often lack sensitivity. Molecular methods offer better speciation and drug resistance profiling for pulmonary NTM but are expensive and not widely available for cutaneous forms. The high cost and limited availability of diagnostic tools necessitate an empirical treatment approach, which is also recommended by the INDEX-Tb guidelines for extrapulmonary tuberculosis. Empirical treatment regimens for NTM, such as combinations of clarithromycin, doxycycline, and cotrimoxazole or fluoroquinolones, have shown promise, but there is a lack of rigorous studies to establish standardized treatments. Monitoring for adverse effects and continued evaluation of the causative organism is essential during empirical treatment, allowing for adjustment if the initial regimen fails.

Background: Dermatophytosis is widespread in India due to recalcitrant and resistant infection. Tinea incognito (TI) is modified dermatophytosis due to the inadvertent use of topical steroids (TS). Similarly, topical steroid-damaged face (TSDF) is caused by prolonged use of TS. Distinction of TI and TSDF is difficult when the face is affected. Dermoscopy can assist in the differentiation of both by revealing characteristic features. We evaluated the dermoscopic features in TI affecting the face and TSDF.

Aims and objectives: To evaluate the clinical and dermoscopic features of TI affecting the face and TSDF. To observe the involvement of eyelids in TI as opposed to TSDF.

Materials and methods: The study was conducted in a tertiary hospital after obtaining ethical clearance and informed consent. Patients with signs of TI or TSDF were enrolled and demographic data were collected. Patients who had applied TS/combination creams were included. A handheld dermoscope with 10x magnification was used. A potassium hydroxide mount was used to confirm the diagnosis of TI.

Results: Out of 80 patients, 27 males and 53 females were present. The mean duration of application was 8.25 ± 7 months. Clinical features were pruritus, erythema, scaling, and burning sensation. Eyelid involvement was noted in TI while it was spared in TSDF. On dermoscopy, morphological features were predominant in TI whereas vascular structures were found in TSDF in addition to white rosettes.

Conclusion: Dermoscopy distinguishes TI from TSDF comprehensively by demonstrating definitive features. In addition, the involvement of the eyelid is an excellent clinical sign of TI.

Since ancient era, tattooing has been very popular, but in the recent times, it has been perceived as a form of art and is quite popular for cosmetic purposes. During the COVID pandemic, while most businesses were struggling, the tattoo industry flourished. This in turn led to an increase in tattooing practices causing a surge in tattoo site complications as well. We hereby present a series of 30 cases of tattoo site reactions which we have encountered as a direct result of tattooing during the pandemic.