Indian Journal of Dermatology最新文献

Background: The prevalence of food allergy (FA) in Iranian children with atopic dermatitis (AD) is unknown. This study aims to determine the prevalence and kind of FA in Iranian children with AD.

Materials and methods: The present investigation was the conducted as a cross-sectional study, with a total of 252 children diagnosed with the AD enrolled as participants. The impression of FA for these patients was made based on history and performing specific immunoglobulin E (IgE) tests. Based on the IgE test results, an oral food challenge (OFC) was performed to confirm the food hypersensitivity.

Results: In AD patients, the prevalence of FA was 28.2%, while the rate of food sensitization was 44.8%. The frequency of food allergies was reported as follows: egg: 10.3%, milk: 9.5%, wheat: 2.8%, tree nut: 2.4%, peanut: 0.4%, soya: 0.4%, and fish: 0.4%.

Conclusion: The prevalence of FA in these Iranian children with AD was determined to be 28.2%, while the prevalence of food sensitization was 44.8%. Egg and milk were found to be the most prevalent food allergens among patients with AD.

Monkeypox is a zoonosis caused by the monkeypox virus. In 2022, the World Health Organization declared monkeypox a Public Health Emergency of International Concern due to its unprecedented global spread. Since June 2023, several new cases have re-emerged in mainland China, underscoring the ongoing transmission risk. Our three cases, confirmed by real-time quantitative polymerase chain reaction with dermoscopic and histopathological findings supporting diagnosis, exhibited atypical symptoms consistent with skin contact-mediated transmission. We propose that, in some patients, lesions may initially develop at the site of contact without preceding systemic symptoms and later disseminate to other body regions.

Background: The Janus kinase (JAK) enzyme plays a crucial role in the pathophysiology of atopic dermatitis (AD). The United States Food and Drug Administration (USFDA) has recently granted approval for three JAK inhibitors intended for AD treatment. These comprise topical Ruxolitinib, oral Abrocitinib, and Upadacitinib. In alignment with these advancements, we developed a topical formulation of Tofacitinib, a JAK inhibitor, and evaluated its potential in mild-to-moderate AD, which has been recently approved on the basis of a phase 3 clinical trial.

Aims and objectives: The present trial was conducted to evaluate the efficacy and safety of tofacitinib ointment 2% w/w (Tof-O) versus pimecrolimus cream 1% w/w (Pim-C) in adult patients with mild-to-moderate AD.

Materials and methods: In this prospective, open-label, multicenter phase 3 trial, 184 patients with mild-to-moderate AD were randomized (1:1) to receive either Tof-O or Pim-C for 4 weeks. The efficacy evaluations included percent change in Eczema Area and Severity Index (EASI) score, percentage of patients achieving EASI 50, 75, and 90% improvement, change in validated Investigator Global Assessment (vIGA-AD) score, change in affected percentage body surface area (BSA), and change in pruritus using numeric scale. Safety and tolerability were assessed by laboratory parameters, physical examination, and adverse events (AEs).

Results: Tof-O significantly (P < 0.05, mean: 1.9709, CI: -4.3327, 8.2745) improved EASI score from baseline after 4 weeks of treatment; the improvement was comparable to Pim-C. Both treatment groups also demonstrated a significant (P < 0.05) increase in the percentage of patients achieving EASI 50, 75, and 90, along with significant (P < 0.05) improvements in vIGA-AD scores, affected BSA, and pruritus from baseline after 4 weeks of treatment. There were no significant changes observed in laboratory values and other safety parameters in both groups.

Conclusion: Tof-O demonstrated favourable safety and efficacy in mild-to-moderate AD patients following 4 weeks of treatment.

Trial registration: Clinical Trial Registry-India (CTRI). CTRI/2022/07/044136 [Registered on: 19/07/2022] Trial Registered Prospectively.

Url: https://ctri.nic.in/Clinicaltrials/showallp.php?mid1=71771&EncHid=&userName=tofacitinib%20ointment.

Type of trial: Interventional.

Primary cicatricial alopecia of the scalp encompasses neutrophilic, lymphocytic, mixed varieties, of which folliculitis decalvans belongs to the neutrophilic group and lichen planopilaris comes under the lymphocytic group. This is a case series of four patients who presented clinically with folliculitis decalvans and histopathology with overlapping features. Four patients presented with a history of painful scalp pustular lesions and hair loss with no other significant history. A clinical diagnosis of folliculitis decalvans was made, and a biopsy for histopathological examination with vertical and transverse sections was studied. The histopathology of cases revealed features consistent with both folliculitis decalvans and lichen planopilaris. Folliculitis decalvans and lichen planopilaris phenotypic spectrum is an emerging entity with fewer cases reported in the literature.

Central sensitization syndromes and neuropathic pain are frequently associated with chronic inflammatory rheumatic diseases such as psoriasis and psoriatic arthritis (PsA). Here, we analyzed the clinical significance of central sensitization (CS) and neuropathic pain, defined as the hyperexcitability of the central nervous system, in psoriasis and PsA patients. Our study included 50 patients with psoriasis aged 45.3 ± 14.4 years, 53 PsA patients aged 41.4 ± 12.7 years, and 50 healthy control group aged 40.7 ± 13.5 years (with similar age and body mass index distribution). Visual analogue scale (VAS), psoriasis area and severity index (PASI) score, health assessment questionnaire (HAQ), minimal disease activity (MDA) scale, self-leeds assessment of neuropathic symptom and signs (S_LANNS), pain-detect questionnaire, and central sensitization inventory (CSI) were used in the study. The presence of CS was in the 68% of patients with psoriasis (N = 34), 35.8% (N = 19) of PsA patients, and 63.6% (N = 21) in control group; neuropathic pain was detected 50% of patients with psoriasis (N = 25), 60.4% (N = 32) of PsA patients, and 63.6% (N = 21) in controls. Frequencies of most common central sensitization syndromes were as follows: anxiety disorder (48%), chronic fatigue syndrome (40%), restless leg syndrome (22%), and depression (22%) in the psoriasis group and chronic fatigue syndrome (39.6%), fibromyalgia syndrome (28.3%), and irritable bowel syndrome (18.9%) in the psoriatic arthritis group. In the linear logistic regression analysis, MDA was found to be strongly related with the CS score (beta = -0.534; P < 0.001). Neuropathic pain and CS are frequently associated with disease activity in psoriasis and PsA patients. These chronic pain syndromes should be considered in management of these diseases.

Background: Vitiligo, an acquired depigmentation disorder, significantly impacts patients' quality of life due to psychological and aesthetic concerns. Surgical techniques such as suction blister (SB) and micro punch grafting (MPG) are used for stable vitiligo, but their effects have not been fully compared.

Aims: This study aims to compare the efficacy of SB and MPG in treating stable vitiligo, focusing on repigmentation outcomes and patient satisfaction.

Materials and methods: This study is a double-blind randomized clinical trial with a self-controlled design. Thirty-one participants were randomized to receive SB or MPG on paired vitiligo patches. Lesions were assessed at baseline, 4 weeks and 12 weeks post-treatment using the Vitiligo Area Scoring Index (VASI) and repigmentation percentages. Data were analyzed using paired t-tests and repeated measures analysis of variance.

Results: Both techniques demonstrated significant increases in VASI and repigmentation over time (P < 0.05). However, MPG showed superior outcomes at 12 weeks, with significantly higher repigmentation rates compared to SB (P < 0.05). Patient satisfaction scores and repigmentation quality were notably better in the MPG group. Adverse effects, including scarring and discolouration, were minimal in both groups.

Conclusion: Both SB and MPG effectively improved stable vitiligo lesions, with MPG showing greater efficacy in repigmentation and patient satisfaction. These findings suggest MPG as a preferred option for stable vitiligo treatment in clinical settings.