Indian Dermatology Online Journal最新文献

Background: Dermatitis cruris pustulosa et atrophicans (DCPA) is a chronic superficial folliculitis that can cause scarring alopecia if left untreated. Hardly any studies are there describing the dermoscopic features of DCPA. Dermoscopy can be a useful tool for diagnosing DCPA in addition to clinical and histopathological features and for differentiating other conditions like superficial folliculitis, folliculitis decalvans, and pseudofolliculitis.

Aims/objectives: The aim of this retrospective study was to describe the dermoscopic features of 30 patients with DCPA at a tertiary care center in South India.

Materials and methods: A retrospective study of clinical and biopsy-proven cases of DCPA at a tertiary care center in South India.

Results: Thirty patients of DCPA of skin phototype IV or V were studied. Male preponderance of DCPA was noted in our study. Lower extremities 28 (93.3%) and upper extremities 2 (6.7%) were the common sites of involvement. The most common findings noted in dermoscopy were follicular-based pustules in 30 (100%) patients, follicular white structureless area in 16 (53.3%), perifollicular collarette of scales in 12 (40%), diffuse background dotted blood vessels in 12 (40%), and the absence of follicular orifices in 12 (40%). Other findings were yellow or hemorrhagic scales, perifollicular linear white lines, broken hair, and perifollicular dotted blood vessels. Pigmentary patterns observed were dark brown pigmentation, blue-grey globules, blue-grey dots, and accentuation of the pigmentary network.

Limitations: The limitations of the study were the retrospective nature of the study, the small sample size, and the lack of a comparison group.

Conclusion: The predominant dermoscopic features observed in our patients were follicular-based pustules, follicular white structureless areas, perifollicular collarette of scales, diffuse background dotted blood vessels, and the absence of follicular orifices. Vascular and pigmentary patterns were less commonly noted.

Background: Plica neuropathica (PN) is an acquired hair disorder characterized by sudden onset, irreversible hair matting, which seems to be a compact hair mass with irregular twists.

Aim and objective: This study aimed to evaluate the clinicodemographic features of PN.

Materials and methods: This study was a cross-sectional prospective clinical research that included patients with PN. All the included patients were subjected to a detailed history of clinicodemographic data and clinical with trichoscopic examinations of the affected hair and scalp.

Results: This study included 18 female patients with PN, with a mean age of 23.94 ± 7.9 years. All the patients presented with PN had acute onset and progressive course, psychological stressful factors preceding PN, negligence of hair care, no history of hair care product use, no history of hair straightening, no previous treatment preceding PN, and no history of systemic diseases. Recurrence of PN was reported in 4 (22.2%) patients. On trichoscopic evaluation, all patients were presented with normal scalp and matting of hair shaft with honey-colored concretions mimicking the "wrangled mesh of wires" appearance. Sixteen (88.9%) patients were treated with cutting hair mass. Most of the included patients reported very large and extremely large effects on the quality of life.

Conclusion: This study concluded that PN is an uncommon acquired hair matting disorder prevalent in young age females. It is associated with marked impairment of the patient's quality of life. Psychological stressful factors and negligence of hair care are the main risk factors for PN. Regular hair care measures are essential to prevent hair matting.

Background: There is only limited data on the association between psoriasis and metabolic comorbidities in South-Asian children.

Objective: To examine metabolic comorbidities among South-Asian children with and without psoriasis.

Materials and methods: A hospital-based, comparative, cross-sectional study was conducted in children with and without psoriasis over 19 months. Anthropometric, clinical, and metabolic comorbidity details (including disease extent and severity scores, obesity, systemic hypertension, diabetes mellitus, lipid abnormalities, and metabolic syndrome) were obtained in both groups according to standard criteria.

Results: Fifty-eight children with psoriasis (25 males/33 females, age 11.3 ± 3.0 years, range 4 to 17 years) and 62 children without psoriasis (37 males/25 females, age 11.0 ± 3.6 years, range 4 to 18 years) were recruited. The prevalence of obesity (31.0% versus 14.5%, P = 0.031, odds ratio 2.65) and metabolic syndrome (18.6% versus 4.6%, P = 0.044, odds ratio 4.68) were higher in children with psoriasis than without. The prevalence of other metabolic comorbidities (systemic hypertension, pre-diabetes, lipid abnormalities, elevated serum alanine aminotransferase, and non-alcoholic fatty liver disease) was not different between children with and without psoriasis and between obese and non-obese children with psoriasis. Among children with psoriasis, those with abdominal obesity had significantly lower disease severity and extent scores than those without.

Conclusion: Psoriasis is associated with a significantly higher prevalence of obesity and close to significantly higher prevalence of metabolic syndrome in South-Asian children. Screening for metabolic comorbidities is essential even in non-obese children with psoriasis. Disease extent and severity are less in obese compared to non-obese South-Asian children with psoriasis.

Background: Subclinical involvement of nerves may sometimes be present much before the overt clinical manifestations become apparent. Protein gene product (PGP) 9.5, a ubiquitin-C-terminal hydrolase, has been widely used as a marker to study the involvement of peripheral nerve fibers in many diseases.

Aim and objectives: To evaluate the change in cutaneous nerve fiber staining and distribution from pre-treatment and post completion of multidrug therapy through the expression of PGP9.5 and to assess PGP9.5 as a marker of treatment response.

Materials and methods: In this prospective single-center observational study, skin biopsy was taken in patients with leprosy, having areas of nerve function impairment (NFI), based on findings of nerve conduction studies (NCSs), but not having lesions or impaired tactile or thermal impairment clinically. The thin nerve fiber density in the clinically normal skin in areas supplied by nerve showing changes of sensory neuropathy was evaluated to study the density of the fibers. A second biopsy was taken at the end of treatment from a site near the previous site to assess the changes in intra-epidermal nerve fiber staining and distribution.

Results: Thirty-three patients were recruited in the present study (24 males and 9 females). Pre-treatment, 27 patients had abnormal NCSs, while six patients did not have any evidence of neuropathy on NCSs. Staining for nerve fibers using PGP9.5; in the epidermis was positive in five patients pre-treatment and 11 patients post treatment (P = 0.181). Staining in the dermis revealed positivity in 14 pre-treatment, which increased to 18 post treatment (P = 0.342). Adnexae showed positivity in five patients pre-treatment and increased to 17 post treatment (P = 0.005).

Conclusion: A reduced PGP9.5 staining in the epidermal, dermal, and adnexal regions was seen in leprosy patients, which improved post treatment. Thus, PGP9.5 may serve as a marker of NFI and treatment response.