Indian Journal of Dermatology最新文献

Erythrodermic psoriasis (EP) is a rare but severe form of psoriasis. Conventional treatments are often ineffective and challenging to maintain; however, new biologic medications have shown promise in the management of EP with limited evidence. To assess the efficacy and safety of two biological treatments, adalimumab and secukinumab, in patients with EP. This single centre study was performed from 8 August 2019 to 12 June 2023. Patients demonstrating psoriasis involving over 75% of body surface area were included. The psoriasis area severity index (PASI) score was recorded during follow-up. A total of 20 patients fulfilling the diagnostic criteria for EP were enrolled in the study. At week 24, 50% improvement of PASI (PASI50), PASI75, PASI90 and PASI100 was reached in 95%, 65%, 45% and 15% of patients, respectively. Adalimumab and secukinumab elicited similar PASI responses. The percentages of PASI responders with comorbidities were lower than that of their counterparts in general. Minor adverse events occurred in 30% of patients, and none was forced to suspend the corresponding drug. A remarkable efficacy was demonstrated by adalimumab and secukinumab in treating EP, with rapid and substantial clinical improvement observed in the majority of patients. Both had a well-tolerated safety profile. However, secukinumab seemingly manifested superior response rates than adalimumab in patients with comorbidities.

Human papilloma viruses (HPVs) are a group of viruses that can infect the stratified epithelium of the skin and mucosa. Based on their oncogenic potential, they can be divided into high risk and low risk types. HPV accounts for 7,30,000 cases of cancers all over the world. In June 2006, the first HPV vaccine - Gardasil - was approved by the FDA. After this in 2007, Cervarix was approved and finally Gardasil 9 in 2014. Currently, there are six prophylactic vaccines against HPV, of which five have been pre-qualified by WHO. The bivalent vaccines offer protection against acquiring HPV 16 and 18, which cause 70% of cervical cancers. The quadrivalent and nonavalent vaccines offer additional protection against low-risk HPV 6 and 11. The currently available vaccines have been found to be safe in both pre- and post-licensure trials. The vaccines offer excellent protection against cervical intra-epithelial neoplasia of grade 2 and 3. The role of HPV vaccines in prevention of other cancers is mostly supported by small retrospective studies. The currently available vaccines are approved for prophylactic use only. There have been attempts to use HPV vaccines therapeutically, and there are conflicting reports regarding their efficacy. This article reviews the currently available vaccines, their indications, adverse effects, contraindications, and epidemiological impact. It also highlights the off label therapeutic uses in various conditions and other potential vaccine candidates.

Melasma is a common skin disorder characterized by facial hyperpigmentation, often aggravated by sun exposure. Antioxidants are being studied as a treatment option for their potential to reduce oxidative stress and improve skin pigmentation. A comprehensive literature search was conducted in PubMed for articles published over the past decade, up to January 31, 2024, on the use of antioxidants in melasma treatment. The systematic review, conducted by two independent investigators, included 30 studies on antioxidants in melasma, covering vitamin C, cysteamine, silymarin, PLE, tomato extract/lycopene, zinc sulfate, melatonin, and other antioxidants. Findings indicated that combining vitamin C with physical therapies, such as peels and lasers, yielded better results. Cysteamine, a naturally occurring aminothiol, showed efficacy comparable to hydroquinone with fewer side effects. Silymarin was effective in reducing melasma severity with minimal adverse effects. PLE showed mixed results but potential as an effective antioxidant when combined with other treatments. Lycopene from tomato extract demonstrated significant improvements in melasma when used as an adjuvant therapy. Zinc sulfate showed some effectiveness but was less potent than hydroquinone. Melatonin had antioxidant capabilities but showed no statistically significant improvement. Glutathione is emerging as a new antioxidant therapy showing efficacy in melasma in combination with other topicals and microneedling. Other antioxidants, including combinations of vitamins C, E, and ferulic acid, showed potential as adjuncts in melasma treatment. These findings highlight the diverse efficacy of antioxidants in managing melasma, suggesting their potential as safe and effective treatments.

Peels are simple, inexpensive office procedures with acceptable side effect profiles and make a good treatment modality for patients with melasma. Glycolic acid peels have been used widely for the treatment of melasma. Due to their tendency to cause undesirable side effects such as post-inflammatory hyperpigmentation, other modalities need to be studied. To compare the efficacy of 80% lactic acid and 50% glycolic acid peel for the treatment of melasma. This was a prospective, single-blinded (study subjects), randomised study. Forty patients with melasma between the ages of 18-50 years from the dermatology outpatient department of a tertiary care hospital in Central India were included in the study and randomised to receive either 80% lactic acid peel or 50% glycolic acid peel (20 in the lactic acid group and 20 in the glycolic acid group) for four sessions at 2-week intervals. The efficacy was assessed using Melasma Area and Severity Index (MASI) scores calculated at the baseline and at the end of the treatment (10 weeks). The pre- and post-treatment MASI scores were calculated for each treatment, and their difference was compared using the Mann-Whitney test. Thirty-four patients completed the study over 6 months and were included in the final analysis. Six patients were lost to follow-up. The median (25^th-75^th percentile) decrease in MASI with glycolic acid 50% peel was 2.85 (1.875-3), which was significantly higher as compared to lactic acid 80% peel, which was 1.8 (1.125-2.4) (P value = 0.009). No significant difference was seen in the side effect profile (P value = 0.105). 50% glycolic acid peel is more efficacious than 80% lactic acid peel for the treatment of melasma.

Background and justification: The cosmetic market is booming all over the world with 25% annual growth in every year. By the year 2025, it is expected that the turn over from the industry will cross 20 billion dollars. After beauty contests that are conducted from various levels and after IT boom in India, the demand and urge for cosmetics has increased among the youngsters. In this context, we have planned to conduct a study on Impact and Effect of cosmetics upon female medical students.

Objectives: 1. To assess the various cosmetics used for skin, hair and nail either daily or periodically. 2. To assess the effect of cosmetics on skin.

Methods: Study population: Female medical students from 2^nd year to CRMI were taken on comparing the usability of cosmetics. Sample size: Twenty-five students from each batches were included. Sampling procedures: A questionnaire on cosmetics usage was issued and the responses were collected. A examination of the skin, hair and nail was done at the end along with skin moisture content analysis. Analysis plan : Univariate analysis.

Results: Acne and scarring noticed among 42 students, atopic dermatitis, xerosis and ichthyosis among 22 students. Their cleansers were not addressed properly. Seborrhoeic dermatitis noticed among 8 students and brittle hair/dry scalp among 9 students whose hair cleansers, oil application practices and hair conditioning techniques were rectified.

Conclusion: In this study, we identified that medical students are also not exceptional for getting obsessed with online marketing, peer influence and irrational cosmetic usage. The adequate knowledge on cosmetics lack in many of our students. This grey area has to be addressed properly among medical students while teaching them.