Acne vulgaris (AV) is one of the most common skin diseases. It is caused by several types of bacterial genera that are resident in the human skin. P. acne in particular is one of the most important causes because it is found in the pilosebaceous units. This study aimed to isolate and identify the common bacteria that cause AV and test the antibiotic susceptibility. Materials:This study ran from April to October 2024. Samples of the study were taken from inflammatory papular and pustular acne lesions from 50 dermatology patients (22 males and 28 females) aged between 18 and 26 years. Results:Staph aureus was the most prevalent bacteria with (29) 43.28% and Staph epidermidis the least common with (3) 4.47%. Sometimes patients had both P. acne and Staphylococcal aureus (12 samples, 17.91%). Both species showed high sensitivity to levofloxacin in the top of the list and the strongest resistance to ampicillin on the other side.
Abstract Soft-tissue tumours are commonly encountered in patients visiting outpatient plastic surgery clinics. Although only a small proportion of these tumours are malignant, misdiagnoses may occur in various clinical contexts. This case series aimed to illustrate the diagnostic challenges associated with soft-tissue tumours and highlight that thorough assessment of the patient’s medical and surgical history, combined with appropriate laboratory investigations, forms the foundation of accurate diagnosis. Additionally, establishing radiological–pathological correlation may help prevent unnecessary surgical interventions and reduce healthcare expenditure. Active patient involvement in the diagnostic process may also mitigate distress in the event of misdiagnosis.
Abstract Background: Codon-specific BRAF mutations are relevant for targeted treatment in melanoma, but Indian data remain limited, and most published studies report only mutant or wild-type status. Aims and Objectives: To evaluate the spectrum of BRAF V600 variants and their clinicopathological associations in cutaneous melanoma from North India. Materials and Methods: Thirty-five primary cutaneous melanomas diagnosed between 2023 and 2025 underwent allele-specific real-time polymerase chain reaction for BRAF exon 15 codon 600 variants. Mutation status was correlated with tumour site and histopathological parameters. Results: BRAF V600 mutations were detected in 19/35 cases (54.3%). V600E was the commonest subtype (31.4%), followed by V600K (8.6%). Rare non-V600E variants (V600R, V600M, V600G, and V600D) accounted for 42.1% of mutated tumours. Mutations were more frequent in non-acral than acral melanomas (65.2% vs 33.3%, P = 0.048). BRAF -mutated tumours also showed non-significant trends towards greater Breslow thickness, higher ulceration rates, and increased mitotic activity. Targetable V600E/V600K alterations were present in 40.0% of cases. Conclusion: Codon-specific testing showed considerable BRAF heterogeneity in this cohort, with a sizeable proportion of non-V600E variants. Broader mutation testing may help identify patients suitable for targeted therapy in routine practice settings.
Abstract Recent studies have highlighted the role of the JAK/STAT signalling pathway in chronic skin conditions such as atopic dermatitis, vitiligo, alopecia areata, lichen planus, and various granulomatous disorders like sarcoidosis, necrobiosis lipoidica, and granuloma annulare. Ruxolitinib is a first-generation JAK inhibitor that the US Food and Drug Administration approved for treating intermediate or high-risk myelofibrosis in 2011. Recently, the topical formulation has been approved to manage mild to moderate atopic dermatitis and non-segmental vitiligo in adults. Encouraging results have been demonstrated with topical ruxolitinib in multiple other skin diseases. This review provides a comprehensive analysis of the use of ruxolitinib in dermatological conditions through a PubMed literature search.
Abstract The global incidence of skin cancer is increasing, with India seeing a marked rise in the last three decades. Skin cancer primarily occurs in white populations, yet the protective effects of eumelanin in darker skin tones do not eliminate the risk of cutaneous malignancy. To conceptualize the burden of skin cancer in India and to assess environmental risks associated with skin cancer as well as the sociodemographic factors that increase disease vulnerability, 1990–2021 Global Burden of Disease Study skin cancer data for India and National Aeronautics and Space Administration air quality data were examined. Additionally, a literature review was conducted in PubMed, Scopus, and Google Scholar using search terms relevant to skin cancer epidemiology, environmental exposures, and social determinants of health. In India, anthropogenic drivers of environmental degradation and climate change including stratospheric ozone depletion, global warming, and air pollution, increase the risk of skin cancer development. However, these health effects are not equally distributed. Geographic factors such as elevation, latitude, sources of drinking water, and regional weather patterns partially determine environmental exposures including ultraviolet radiation, arsenic, heat, and air pollutants. Sociodemographic disparities in skin cancer burden in India are also observed, including gender, occupation, and socioeconomic status, which further effect exposure to climate hazards, access to care, and sun protection practices. Key environmental and demographic factors contribute to India’s rising rates of skin cancer. The implications extend beyond India, and demonstrate a pressing need for practical climate adaptation strategies for low- and middle-income countries.
Abstract Steatocystoma multiplex is characterised by skin-coloured papules and nodules over various parts of body. Hidradenitis suppurativa is a chronic inflammatory disorder characterised by nodules, discharging sinuses and scarring. Aquagenic keratoderma is characterised by thickened skin of palms and soles with white translucent papules which increases on water exposure. A 28-year-old male presented with progressively increasing asymptomatic yellowish papules and nodules without punctum or discharge over his face for 10 years. He also developed recurrent painful nodules with discharging sinuses and puckering of skin over bilateral axillae, groin, trunk, and buttocks for the last 2 years, with thickening of skin over the dorsal aspect of bilateral hands and feet for 1 year, which got accentuated on water exposure. Skin biopsies were done from lesions over the face, axillae, and hands, and histopathology findings were consistent with steatocystoma, hidradenitis suppurativa, and keratoderma, respectively. The patient was started on oral isotretinoin 0.5 mg/kg daily, topical clindamycin twice daily over axillae and urea-based emollient twice daily over hands and feet. There was complete resolution in nodules and sinuses and mild improvement in steatocystoma and keratoderma lesions after 6 months. We present this case due to the rarity of coexistence of the three conditions in a single patient, the unusual location of steatocystoma and aquagenic keratoderma, and possibly a new impending follicular occlusion pentad considering the addition of steatocystoma to the existing tetrad.
Neural networks (NNs), a subset of artificial intelligence (AI), have the ability to assess the severity of vitiligo and improve diagnosis accuracy. In contrast to human physicians' diagnosis, which is primarily based on subjective assessment, standardised and objective diagnostic methods are needed to provide an accurate diagnosis and grade the severity of vitiligo. The aim of this study is to analyse the sensitivity and specificity of AI in vitiligo diagnosis and severity assessment. The PRISMA 2020 protocol was followed to screen literature in several databases: Proquest, PubMed, Taylor and Francis, SAGE, JSTOR, and ScienceDirect. Human studies that investigated the potential of AI in vitiligo diagnosis were included in vitiligo diagnosis were included. Statistical analysis was carried out using RevMan 5.4 and RStudio, and risk of bias tools were used to assess study bias. Certainty of evidence was analysed using GRADE. The systematic review consisted of 15 studies, and seven studies were statistically analysed. The most studied NNs were Inception V3 (n = 2), visual geometry group (n = 2), and ResNet (n = 2). The overall sensitivity ranged from 72.5% to 99.7%, with a pooled sensitivity of 95.5%. Specificity ranged from 72% to 99.9%, with a pooled specificity of 97%. Among the evaluated models, Inception V3 showed the highest diagnostic performance. The summary receiver operating characteristics curve (SROC) from multiple analyses showed an area under the curve of 0.96. AI showed potential in diagnosing and evaluating the severity of vitiligo.
Background:Acute skin graft-versus-host disease (GVHD) is a common and early complication of haematopoietic stem cell transplantation (HSCT). Diagnosing GVHD through histopathology alone can be challenging due to overlap with other conditions. Tissue elafin immunohistochemistry (IHC) has shown potential as a diagnostic tool, but studies report conflicting results. Objectives:To examine the utility of elafin IHC in skin biopsies for accurate acute skin GVHD diagnosis in HSCT recipients. Methods:Consecutive allogenic HSCT recipients in a tertiary care centre in South India, who developed rash within the first 100 days post-HSCT during a 17-month period were recruited. Skin biopsies were taken on the day of rash and epidermal elafin IHC was done. Staining of >50% of the epidermis was considered positive. The final diagnosis of skin GVHD was assigned using a composite criteria of clinical features, histopathology and response to treatment. We evaluated the accuracy of elafin IHC in GVHD diagnosis. Results:Sixty-eight skin biopsies from 58 patients (median age 14 years; range 1-53; 46 males) were analyzed. Median day of rash onset was 23.5 (range: 5-98). GVHD was confirmed in 45 (66.2%) episodes. Elafin IHC was positive in all GVHD and 9/23 non-GVHD cases, six of which were engraftment syndrome. The sensitivity and specificity of elafin IHC were 100% and 58.3%, respectively. There was a significant correlation between positive elafin IHC and GVHD (P < 0.0001). Conclusion:Tissue elafin is a highly sensitive IHC marker for diagnosis of acute skin GVHD, including cases without classic histopathological findings. However, its utility is limited in distinguishing GVHD from engraftment syndrome.
Psoriasis is a chronic, debilitating disease of inflammatory dermatoses. IL-17 plays a pivotal role in the pathogenesis of psoriasis. It acts as a driving force in psoriasis and has a significant role in keratinocyte proliferation, plaque progression, neutrophil recruitment, forming an amplification loop, and formation of tissue-resident memory T helper cells causing relapse. Ixekizumab is a humanized IgG4 monoclonal anti-IL-17 antibody approved for psoriasis in 2016. We are reporting a series of 22 patients presented with moderate to severe psoriasis treated with ixekizumab. 31.8% of patients had pre-existing comorbidities like Hypertension, diabetes, or hypertriglyceridemia. After 14 weeks of treatment, the Mean ± SD PASI improved from 30.82 ± 7.06 to 2.82 ± 3.12. At the end of treatment (14th week), PASI75, PASI 90, and PASI 100 were achieved by 95.45%, 68.18%, and 27.27% of patients, respectively. Friedman's ANOVA shows a significant decrease (P < 0.05) in PASI, BSA, and sPGA scores starting from the 1st follow-up (2 weeks) onwards. Paired t-test shows a significant decrease in PAsI, BSA, and sPGA reduction, P < 0.0001 between baseline and 7th follow-up visit (14 weeks). No significant side effects were noted in this period. The present study illustrates the experience with ixekizumab in real-world clinical practice, confirming its effectiveness and safety in the management of plaque psoriasis patients.
Abstract Background: Melasma is a pigmentation disorder of the face that is influenced by genetics, hormones, and exposure to ultraviolet light. Workers who are exposed to sunlight have a high risk of developing melasma, including female fish dryers. Aims: This study aims to analyse the correlation between the use of sunscreen and physical sun protection in the prevention of melasma among female fish dryers at Olo Belawan Beach. Settings and Design: This study used a cross-sectional design with 61 participants. Materials and Methods: Data were collected using questionnaires with structured interviews and physical examination of the face. Statistical Analysis Used: Data were analysed using Fisher’s exact test and G-test with a significance level of P < 0.05. Results: The analysis showed that 57.4% of the participants did not use sunscreen, while 42.6% used sunscreen. Melasma was found in 41% of the 61 participants. Most participants (83.6%) used physical sun protection with a high level of use, which included hats, long sleeves, gloves, masks, and footwear. There was a significant association between sunscreen use and melasma incidence ( P = 0.001), suggesting that sunscreen use may reduce the risk of melasma. However, the use of physical sun protection did not show a significant association with the incidence of melasma ( P = 0.616). The combination of sunscreen and physical sun protection use was shown to provide the best protection against sun exposure, with a statistically significant association ( P = 0.001). Conclusion: This study concludes that combining sunscreen and physical sun protection offers the best protection against melasma in female fish dryers at Olo Belawan Beach.
Background:Topical Steroid Damaged/Dependent Face (TSDF) is described as 'the semi-permanent or permanent damage to the skin of the face precipitated by the irrational, indiscriminate, unsupervised, or prolonged use of TCs resulting in a plethora of cutaneous signs and symptoms and psychological dependence on the drug'. Its management is difficult due to the unavailability of a universally accepted treatment regimen, as well as a high rate of rebound after stopping therapy. Aim:To study the efficacy and safety of the application of 10% tranexamic acid solution in Topical Steroid Damaged/Dependent Faces. Methods:In this non-randomised interventional study, 15 cases with TSDF were treated with topical 10% tranexamic acid solution applied once daily for 8 weeks and followed up every 4 weeks up to 12 weeks. Erythema, the hallmark of TSDF, was graded based on the Clinician's Erythema Assessment (CEA) scale, and improvement in this score was recorded at every follow-up visit along with clinical photographs. Results:Erythema, photosensitivity and telangiectasia were present in all our subjects, followed by pigmentary abnormalities, acneiform eruptions, hypertrichosis and atrophy. Based on the reduction in CEA, we recorded a statistically significant improvement in erythema at week 4, and complete resolution of the same in 100% of our subjects by week 8. Conclusions:Topical 10% tranexamic acid solution is a novel, promising, safe and efficacious modality in the treatment of TSDF.
Introduction:Alopecia areata (AA) is a chronic folliculocentric inflammatory disease with hair loss ranging from patchy to diffuse involvement, with a chronic remitting and relapsing course. It has a multifactorial pathogenesis and immense psychosocial implications. Janus kinase/signal transducers and activators of transcription (JAK-STAT) pathway involving the inhibition of interferon-gamma (IFNγ) and subsequent inflammatory cytokine cascade is its key mechanism of action. Aim:To determine the effectiveness and safety profile of oral tofacitinib in alopecia areata. Materials and Methods:A total of 30 patients with extensive AA, not responding to conventional therapies, were included in this study. Clinical assessment was performed by Severity of Alopecia Tool (SALT) score and dermoscopic assessment by alopecia areata predictive score (AAPS). Results:SALT score at 6 months showed a mean SALT reduction of 79.27% (43.33% of patients), followed by 93.16% (26.67%), 28.24% (20%), and 3.76% (10%). Similarly, at 6 months, we observed a positive change in AAPS of 4.25 (>90% SALT reduction) followed by 2.9 (50%-90%), 1.66 (10%-50%), and 1 (<10%). Highly statistically significant results were achieved. Autoimmune thyroid disease was the most common comorbidity. Mild side effects were observed and managed with dose reduction. Limitations:These included small sample size, less follow-up periods, lack of controls, and non-responders. Conclusion:Oral tofacitinib showed promising results, with most patients showing a >50% (mean = 79.27%) SALT reduction and a mean 2.9 dermoscopic positive change in AAPS assessment. Mild or no side effects were observed.
