Indian Dermatology Online Journal最新文献

Background: Acanthosis nigricans (AN) features thick, hyperpigmented skin in flexural areas, often indicating insulin resistance. Dermoscopy of AN demonstrates sulci cutis and crista cutis, and differentiates it from other pigmentary dermatoses. Comparative efficacy studies are lacking in the literature. This study evaluates the clinical and dermoscopic changes in AN treated with metformin and pioglitazone.

Patients and methods: A randomised open-label trial was conducted on consenting AN patients aged 18 years or older. Patients were randomized to receive either metformin 500mg twice a day or pioglitazone 7.5mg twice a day for 3 months. Clinical grading, anthropometric measurements, and dermoscopic features were compared at baseline and at study completion at 12 weeks using IBM SPSS v26.

Results: Sixty-five patients (mean age 35 years) were distributed between two groups. Both drugs significantly improved clinical grading from baseline to 12 weeks. Metformin notably reduced the body mass index (29.55 ± 3.51 kg/m 2 to 28.92 ± 3.44 kg/m 2 ) and weight (76.58 ± 10.21 kg to 74.64 ± 10.30 kg) more than pioglitazone, but there were no significant differences in other parameters. Both drugs significantly changed dermoscopic parameters, including sulci cutis and hyperpigmented dots and globules, with no differences between them. Papillary projection morphology correlated significantly with clinical grading.

Limitations: The limitations of this study include a relatively short study duration, and a lack of assessment of the effect of patient and disease-related factors on treatment response.

Conclusion: Metformin and pioglitazone both significantly improved AN clinically and dermoscopically, with no significant differences in efficacy between them. Metformin is more effective in reducing weight and body mass index, and is suitable for overweight patients. Pioglitazone is an alternative for those intolerant or unresponsive to metformin. Dermoscopic parameters can indicate early treatment response before visible clinical improvement.

Objective: This study evaluated the accuracy, readability, understandability, and actionability of ChatGPT-3.5 responses to common patient questions about systemic isotretinoin therapy.

Materials and methods: Thirty questions were developed in five categories (drug information, side effects, pregnancy, daily life, and course of treatment) based on resources from the British Association of Dermatologists and the Turkish Dermatology Association. Questions were presented to ChatGPT-3.5, and responses were evaluated using a four-point Likert scale for accuracy, the Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE) for readability, and the Patient Education Assessment Tool for Printed Materials (PEMAT-P) for understandability and actionability.

Results: Of the 90 evaluations, 44.4% of responses were comprehensive and correct, 18.8% were correct but insufficient, 32.2% were mixed with outdated data, and 4.4% were completely incorrect. The average FKGL was 13.28 ± 2.38, and the FRE score was 29.34 ± 10.4, indicating a college graduate reading level. PEMAT-P scores for understandability and actionability averaged 48.1% and 35.06%, respectively, falling below the 70% threshold. The "daily life" section had the highest scores for both metrics, while "pregnancy and contraception" scored the lowest.

Limitations: This study was limited to ChatGPT-3.5, conducted in English, and based on training data available only up to 2021, which may affect the generalizability and currency of the results.

Conclusion: While ChatGPT-3.5 shows potential as a patient education tool, it struggles to provide accurate, readable, and actionable information on systemic isotretinoin therapy. Its use requires supervision, and further refinement of artificial intelligence tools is needed to improve their utility in healthcare settings.

Background: Microneedling is one of the cost-efficient and safe procedures for treatment of atrophic scars. Previous studies have shown variable results regarding the increased efficacy of platelet-rich plasma (PRP) when combined with microneedling.

Objectives: The aim of this split-face study was to compare the efficacy of PRP combined with microneedling versus microneedling alone in acne scars in type 3-6 skin in South Indian patients. The primary objective was to compare the mean reduction in acne scar using Goodman Baron quantitative scale on the side of the face treated with PRP and microneedling, with the side of the face treated with microneedling alone.

Patients and methods: A total of 64 patients were recruited, and three sessions of microneedling with PRP on the right side and microneedling on the left side were done with an interval of 4 weeks between the sittings. Results were evaluated after 1 month of the last sitting using Goodman and Baron's score and physician and patient satisfaction score.

Results: There was significant improvement in atrophic acne scars on both sides of the face before and after treatment. While comparing efficacy between sides, the side treated additionally with PRP had significantly more improvement than the side treated with microneedling alone.

Limitations: The trial was non-randomized, and complete blinding was not done. The study had a shorter follow -up interval. We did not analyze results based on the site of scar.

Conclusion: PRP combined with microneedling is more effective than microneedling alone for the treatment of atrophic acne scars. Larger studies with longer follow-up are needed to confirm this result.