Application Of Cream Research Articles

Early treatment of vulvar synechiae in childhood - prevention of late complications.

Synechiae of the vulva occurs especially in girls in the so-called resting hormonal period with a minimal serum concentration of estrogens. If the external genitalia of the girl are not treated properly, the mucous membrane of the vaginal entrance is not regularly checked and mechanically removed, then the smegma of the opposite mucous membranes of the vulva can stick together. The place of the adhesion of epithelium in the vaginal introitus can be covered by a new epithelium and can create a firm adhesion, synechiae of the vulva, which is usually asymptomatic and is discovered incidentally during pediatric examination. Clinically significant vulvar synechiae can cause impaired bladder evacuation and recurrent lower urinary tract infections. Dissection of synechiae in the stage of conglutination or thin adhesion is performed manually on an outpatient basis, but extensive and firm adhesions must be divided surgically under general anesthesia. Local application of cream with estriol or betamethasone is also used for the therapy of synechiae of the vulva, but this treatment is more time-consuming compared to rapid manual separation and requires good compliance of the girls and their parents. The prevention of synechiae is based on the education of parents by pediatricians and gynecologists about the need for regular checks of the external genitalia and sufficient hygiene.

Gallic Acid Treats Hypertrophic Scar in Rabbit Ears via the TGF-β/Smad and TRPC3 Signaling Pathways.

Hypertrophic scars (HSs) develop due to excessive collagen deposition and abnormal fibroblast proliferation during wound healing, significantly impacting patient quality of life. Three dosages of GA ointments were administered to rabbit ear HS models to investigate the potential efficacy and mechanism of gallic acid (GA) on HS. Daily application of ointment was performed on the matrix group, the GA ointment groups, and the silicone gel group for 28 days. (No drug treatment was performed on the skin and model groups as a blank group and vehicle group, and silicone gel ointment was topically administered to the silicone gel group as a positive control group.) Scar specimens were collected for histopathology analysis, RNA sequencing analysis, real-time quantitative polymerase chain reaction, and Western blot analysis at the first, second, and fourth weeks after the treatment. Low-dose and medium-dose GA effectively suppressed HS formation and markedly decreased fibroblast infiltration levels and scar thickness. Moreover, decreased expression of TRPC3 mRNA and TGF-β1, p-Smad2/3, and Smad2/3 protein was observed in the low- and medium-dose GA groups and the silicone gel group. This study provides evidence for the efficacy of GA in treating HS and sheds light on its potential underlying pharmacological mechanisms.

Effects of skin moisturization on various aspects of touch showing differences with age and skin site

The human body is encompassed by a thin layer of tissue, the skin, which is heterogenous and highly specialized to protect the body and encode interactions with the external world. There is a fundamental scientific drive to understand its function, coupled with the need to preserve skin as we age, which impacts on our physiological and psychological well-being. In the present study, we aimed to define differences in touch perception between age groups and with skin cream application. We investigated touch on the finger, the forearm and cheek in younger (20–28 years, n = 22) and older (65–75 years, n = 22) females. We measured skin hydration, touch detection, finger spatial discrimination, forearm tactile pleasantness together with electrodermal activity, and perceptual ratings about cream use, skin dryness, and cosmetic habits. Glabrous finger skin became drier and touch performance was impaired with age, but these aspects were preserved in hairy skin. Skin moisturization immediately increased hydration levels, but did not significantly change touch perception. We also found that touch appreciation increased with age. We conclude that reduced finger capacity may impact self-evaluation of the skin and that long-term skin care strategies should focus on hydrating the hand to preserve touch capacities.

Labial Adhesions

Labial adhesion is characterized by partial or complete fusion of labia minora or labia majora. It is rare in menopausal women. It is usually a triad of estrogen deficiency, inflammatory skin disorders and lack of sexual activity. Patients are mostly asymptomatic until labial fusion is complete. The most common symptoms are urinary retention and urinary tract infections and incontinence. It is usually diagnosed on examination of external genitalia. The treatment is not well established, owing to low prevalence in menopausal population. The most common methods of treatment are manual separation and surgical excision. Postoperative application of local estrogen cream is vital to prevent recurrence.

Surgeons' practice and preferences for the anal fissure treatment: results from an international survey.

The best nonoperative or operative anal fissure (AF) treatment is not yet established, and several options have been proposed. Aim is to report the surgeons' practice for the AF treatment. Thirty-four multiple-choice questions were developed. Seven questions were about to participants' demographics and, 27 questions about their clinical practice. Based on the specialty (general surgeon and colorectal surgeon), obtained data were divided and compared between two groups. Five-hundred surgeons were included (321 general and 179 colorectal surgeons). For both groups, duration of symptoms for at least 6weeks is the most important factor for AF diagnosis (30.6%). Type of AF (acute vs chronic) is the most important factor which guide the therapeutic plan (44.4%). The first treatment of choice for acute AF is ointment application for both groups (59.6%). For the treatment of chronic AF, this data is confirmed by colorectal surgeons (57%), but not by the general surgeons who prefer the lateral internal sphincterotomy (LIS) (31.8%) (p = 0.0001). Botulin toxin injection is most performed by colorectal surgeons (58.7%) in comparison to general surgeons (20.9%) (p = 0.0001). Anal flap is mostly performed by colorectal surgeons (37.4%) in comparison to general surgeons (28.3%) (p = 0.0001). Fissurectomy alone is statistically significantly most performed by general surgeons in comparison to colorectal surgeons (57.9% and 43.6%, respectively) (p = 0.0020). This analysis provides useful information about the clinical practice for the management of a debated topic such as AF treatment. Shared guidelines and consensus especially focused on operative management are required to standardize the treatment and to improve postoperative results.

Diaper dermatitis and associated factors among 1–24 months children visiting public health facilities of Arba Minch town, Gamo zone, southern Ethiopia

BackgroundDiaper dermatitis is one of infants and toddlers' most common skin diseases; it accounts for 10–20 % of all skin diseases and 25 % of pediatric dermatology visits. Diaper dermatitis also increases parents' mental health problems and compromises the quality of life. Despite its ill outcome, diaper dermatitis's burden and risk factors are poorly studied in Ethiopia. Therefore, this study aimed to assess the magnitude of diaper dermatitis and associated factors among 1–24 months children visiting public health facilities in Arba Minch town, southern Ethiopia. MethodsA facility-based cross-sectional study was conducted among 671 mother-child pairs from May 15 to June 15, 2022. A structured and pretested interviewer-administered questionnaire and observational checklist were used to collect the information. The data was collected using an open data kit tools and analyzed using Stata version 17.0. Bivariable and multivariable analyses were carried out to identify factors associated with diaper dermatitis. P-value <0.05 was considered to declare statistical significance. ResultsIn this study, 664 mother-child pairs, yielded a response rate of 98.96 %, were involved. Overall, 35.69 % [95 % CI: 32.04, 39.47] of children encountered diaper dermatitis. Being government-employed (AOR: 2.49, 95 % CI: 1.42, 4.35), primiparity (AOR: 1.52, 95 % CI: 1.03, 2.23), unplanned pregnancy (AOR: 1.93, 95 % CI: 1.22, 3.04), having poor knowledge about diaper dermatitis (AOR: 1.74, 95 % CI: 1.19, 2.56), using both disposable and non-disposable diapers alternatively (AOR: 3.35, 95 % CI: 1.55, 7.22), and applying ointments on diaper area (AOR: 1.93, 95 % CI: 1.26, 2.97) all increase the likelihood of diaper dermatitis. ConclusionDiaper dermatitis was high in the study hospitals; over one-third experienced it. Maternal occupation, parity, pregnancy status, maternal knowledge of diaper dermatitis, diaper type, and ointment application were significantly associated with diaper dermatitis. Improving maternal/guardian knowledge about diapering and diaper dermatitis is critical to reducing the burden and severity of the problem.

Therapeutic efficacy, safety, and tolerability of a topical agent (foam cream 5 % urea)

The article presents the results indicating a high level of safety and good tolerability of the topical agent (foam cream 5 % urea). The results of the clinical studies have shown high therapeutic efficacy of foam cream 5 % urea in the complex treatment of topical dermatitis, psoriasis, itching, and damage to the integrity of the foot skin in diabetes mellitus. The index of quality of life of patients improves significantly against the background of the foam cream application; high efficiency and good tolerability of the agent with its regular use have been demonstrated. The conducted studies allow recommending the use of the topical agent (foam cream 5 % urea) as a safe and effective remedy, including for the treatment of pregnant women and children.

Surgical wound infection by Pluralibacter gergoviae in a diabetic patient

is reported to cause infections in immunocompromised patients and also nosocomial outbreaks. This is a case of soft tissue infection in a diabetic patient who underwent a surgery on the left breast and a bilateral reduction mammoplasty following all preliminary investigations. Post operatively, she presented with the complaints of poor wound healing and a wound gap. Immunocompromised state, uncontrolled diabetes and topical application of cream or ointment during post-operative period could be risk factors for an infection by Little is known about this organism and its clinical significance. Hence documentation of such case scenarios is essential to gather more clinically relevant information.

Efficacy and In-Use Tolerance of Venusia Baby Moisturizer for Skin Hydration in Babies With Dry and/or Normal Skin.

Introduction Skin hydration is important for maintaining adequate skin barrier function. After delivery, the baby's skin faces the most difficult challenge as they are exposed to the exterior world's environmental changes, friction, and microorganisms. The management is further complicated by the availability of a large range of infant skin-care products with varying claims. The first-ever Indian study on babies was done to analyze the test product (Venusia baby moisturizer; Dr.Reddy's Laboratories Ltd., Hyderabad, India) in order to bring scientific clarity to consumers. This product is devoid of parabens, alcohol, and animal origin (Dr.Reddy's Laboratories Ltd., Hyderabad, India) and is designed for skin hydration and in-use tolerance in babies with dry and/or normal skin. The endpoints were hydration and clinical evaluation of the skin, evaluated using a moisture meter scale (MMSC; Delfin Technologies Ltd., Kuopio, Finland) and parent self-assessment questionnaire, respectively. Material and methods A total of 136 healthy babies aged between six months to two years were enrolled in a four-group, monocentric, non-randomized, evaluator-blinded study: Group 1 (Venusia baby cream for dry skin), Group 2 (Venusia baby lotion for Dry Skin), Group 3 (Venusia baby cream for normal skin), and Group 4 (Venusia baby lotion for normal skin). The endpoints were hydration and clinical evaluation of the skin, evaluated using an MMSC and parent self-assessment questionnaire, respectively. Results In babies with dry skin, skin hydration was improved with Venusia baby cream (37.50%) and Venusia baby lotion (66.40%). Additionally, 66.66% of participants strongly agreed that the baby's skin became softer and smoother after the application of Venusia baby cream; 76.47% of participants strongly agreed that the baby's skin became softer and smoother after the application of Venusia baby lotion. In babies with normal skin, skin hydration was improved with Venusia baby cream (12.20%) and Venusia baby lotion (7.20%); 59.37% of participants strongly agreed that the baby's skin became softer and smoother after the application of Venusia baby cream; and 84.84% of participants strongly agreed that the baby's skin became softer and smoother after the application of Venusia baby lotion. Conclusion Significant improvement was seen in skin hydration using Venusia baby cream and Venusia baby lotion in babies with dry skin and normal skin. No skin intolerances and product-related adverse or serious adverse events were clinically observed or reported during the study duration. Venusia baby lotion had the highest effect (66.4%) on skin hydration in babies with dry skin, where there was a significant shift from dry skin to normal skin range.

A Surgical Management and Histopathological Study of an Extensive Perianal Sebaceous Gland Adenitis in a Jersey Crossbred Cow

Introduction: Sebaceous gland adenitis is a rare condition found in large ruminants, eluding diagnosis and potentially progressing into neoplastic states if left untreated. The aim of the current study was to indicate the benefits of surgical excision of sebaceous gland adenitis in a Jersey crossbred cow. Case report: A 6-year-old Jersey crossbred cow weighing 300 kg was admitted to the Teaching Veterinary Clinical Complex, Mannuthy, Thrissur, Kerala, India, in December 2022 with a soft tissue mass in the right vulval lip. Initially observed as a small skin bump, the condition had progressively worsened over 2 months, becoming an extensive mass contaminated with external debris and live maggots. Palpation revealed the mass to be firm without eliciting pain. The physiological parameters, such as rectal temperature, heart rate, and respiratory rate were within normal limits. The hematological and serum biochemical parameters were normal. The mass was resected surgically, and the vulval lip was reconstructed. Postoperatively, the cow received a 5-day course of enrofloxacin (Enro, India) at a dosage of 5 mg/kg body weight, along with 3 days of intramuscular meloxicam at a dosage of 0.2 mg/kg body weight and topical application of antiseptic ointment (Lorexane, India). The animal had an uneventful recovery after 2 weeks. Histopathological analysis confirmed the diagnosis as sebaceous gland hyperplasia and chronic adenitis. Conclusion: This study demonstrated that timely diagnosis and excision of the vulval tissue mass resulted in a complete recovery and preserved the animal's value. Chronic sebaceous gland adenitis may have a tendency to transform into a benign tumorous condition. The early presentation of the animal and successful surgical intervention prevented this transformation of sebaceous gland adenitis to a benign or malignant condition.

"Free-Floating Anus": A Flap-Free Approach for Definitive Excision of Circumferential Giant Condyloma Acuminata.

Giant condyloma acuminata (GCA), or Buschke-Löwenstein tumor, is a rare exophytic cauliflower-like growth in the anogenital region. The spectrum of treatment options is wide, ranging from the application of topical ointments to the performance of an abdominoperineal resection. Currently, wide local excision is the most common approach and may entail the creation of a protective loop ileostomy or implementation of flaps or grafts that facilitate closure. We describe a unique surgical approach for the management of circumferential GCA void of the use a protective loop ileostomy, flaps, or grafts. Our report highlights that the implementation of a radical, circumferential, wide excision resulting in "free-floating anus" and healing via secondary intention can ultimately lead to excellent functional and cosmetic results and therefore may be considered a minimally invasive surgical option for patients afflicted with a large, circumferential GCA.

Electrocardiogram Cream Reduces Skin-Electrode Impedance Upon Neuromuscular Monitoring Using TOF-Cuff®.

Background Mechanistic insight into the high failure rate of TOF-Cuff®(RGB Medical Devices, Madrid, Spain) measurements on the lower leg is unclear. Aims We aimed to determine whether materials applied to pseudo-skin can reduce the impedance between a model arm and TOF-Cuff® electrodes and whether a material between TOF-Cuff® electrodes and the patient's skin surface decreases the skin-TOF-Cuff® electrode impedance within the appropriate range. Methods This was a combination of an in vitro study using non-living materials and a prospective observational clinical study. Eight patients aged > 70 years who had undergone elective surgery were eligible. One of the primary outcomes was whether water, electrocardiogram (ECG) cream, or ECG gel applied on the pseudo-skin could reduce the impedance between the model arm and the TOF-Cuff® electrodes in the in vitro study. Another was whether a material between the TOF-Cuff® electrodes and the patient's skin surface decreased the skin-TOF-Cuff® electrode impedance to an appropriate level of less than 5,000 Ω in the clinical study. Results The application of water, ECG cream, and ECG gel similarly reduced the impedance values within the electrical circuit in the in vitro study. ECG cream application between the patient's skin surface and the TOF-Cuff® electrodes decreased the skin-TOF-Cuff® electrode impedance (median (interquartile range (IQR)) Ω) from 8,600 (6,450 to 9,775) to 2,000 (1,600 to 2,600) (P = 0.012) in surgical patients. Conclusion ECG cream application between the patient's skin surface and the TOF-Cuff® electrodes decreased the skin-TOF-Cuff® electrode impedance appropriately, and thus, the application can facilitate precise TOF-Cuff® measurements in patients.

The Effectiveness of Using CO2 Fractional Laser and Mebo Burn Ointment Together in Treating Scars on the Face after Surgery.

This study aimed to investigate the efficacy and safety of CO2 fractional laser combined with Mebo burn ointment in treating facial postoperative scars. Sixty patients with facial postoperative scars in the department of plastic surgery of Sun Yat-sen Memorial Hospital from January 2020 to June 2022 were divided into a control group (30 cases) and a study group (30 cases). Both groups received CO2 fractional laser treatment, but the study group also received Mebo burn ointment application. The study found that both methods resulted in a significant decrease in Sawada score and a significant increase in Investigator Global Assessment score after treatment (P < 0.05), with the study group showing a more significant improvement and higher patient satisfaction (P < 0.05). All patients experienced varying degrees of bleeding, swelling, and erythema immediately after treatment, with two cases of pigmentation and two cases of persistent erythema in the control group, and one case of pigmentation and one case of persistent erythema in the study group. Adverse reactions were minimal, with the study group showing better tolerance. The study suggests that CO2 fractional laser combined with Mebo burn ointment is an effective and safe treatment for facial postoperative scars.

Acupoint application of Yao medicine hydrotherapy ointment in patients with insomnia

Acupoint application of Yao medicine hydrotherapy ointment in patients with insomnia

P11 Pooling the evidence: a review of swimming and atopic dermatitis

Abstract Swimming is an excellent form of aerobic exercise and is an essential life skill. Many children with atopic dermatitis (AD) are advised not to swim because of concerns about negative impacts on their skin disease, and some children with AD do not swim because they are self-conscious about the appearance of their skin. We aimed to review the available literature on swimming and AD and scientifically analyse the potential impact of all components of swimming in AD – water, skin barrier, swimming gear and exercise. Studies examined the impact of swimming on the skin barrier and relative contraindications to swimming. Constituents of water that may affect AD include hardness, pH, temperature, antiseptics and other chemicals. Potential interventions to reduce damage included emollient application, special swim gear, and showering post-submersion. The benefits of swimming as a form of exercise in AD included reduced sweating, cardiorespiratory fitness and maintenance of healthy weight. Drawbacks of swimming as a form of exercise in AD included the limited benefit on bone mineral density. Future research should examine the impact of swimming on flares of AD using noninvasive biomarkers as well as clinical severity assessment, and assess the role for different types of emollient as an intervention for optimal eczema control. Based on the review we provide new guidance on how to advise parents and children with AD regarding general measures, swim wear, and pool-side interventions to minimize any deleterious effect on skincare, and maximize opportunities to swim.

Investigating the efficacy of topical application of Ipomoea carnea herbal cream in preventing skin damage induced by UVB radiation in a rat model

Ultraviolet-B irradiation is a common environmental stressor that has detrimental effects on human skin. Natural sunscreens are well-known for their ability to benefit inflamed sunburn and dry skin. This study examined the effect of formulated Ipomoea carnea herbal cream on UVB-induced skin damage. We screened the bioactive compounds of I. carnea crude extract, showing significant antioxidant activity. Additionally, we evaluated the cytotoxicity, revealing that I. carnea extract has less toxicity to vero cells (IC50 98.45 μg/mL) than to A375 cells (IC50 48.95 μg/mL). Based on this, we formulated the I. carnea herbal cream (FIHC) at 50, 100 and 200 mg concentrations and evaluated its organoleptic characteristics. Then, the rats were exposed to UVB radiation (32,800 J/m2) four times/week (on alternate days) before the cream was applied topically to the dorsal skin surface. Under UVB stress without treatment, rats showed deep dermal damage. In contrast, rats treated with the FIHC exhibited significantly reduced sunburn. Moreover, the histopathological and biochemical assays were confirmed by the topical application of FIHC, which had potentially reduced the skin elasticity and maintained the imbalanced enzyme and non-enzymatic antioxidant activity. Our findings amply demonstrate that the FIHC significantly accelerated the recovery of UVB-induced lesions through antioxidant and down-regulation of skin photodamage.

The Effect of Nigella Sativa Oil on Imiquimod Induced Model of Psoriasis in Thin Skin of Adult Male Mice. A Histological Study

Abstract Background Psoriasis was reported to be a chronic, immune-mediated inflammatory skin disease. Psoriasis can be induced in mice by Imiquimod which is an immune response modifier and it is the most widely used animal model of psoriasis. Nigella sativa oil is frequently used for its antiinflammatory and anti-oxidant activities. The current study is aimed to assess the effect of oral Nigella Sativa oil on imiquimod induced model of psoriasis in thin skin of adult male mice. Materials &amp; methods The current study included twenty male albino mice. After seven days acclimatization period, animals were subjected to shaving of square shaped area 2 x 2 cm2 at the backs of all mice. Then, animals were divided into three groups: Group I: Control, n = 10: subdivided into: Subgroup IA (Negative Control), Subgroup IB: which received a daily dose of 20 mg of Nigella sativa oil orally. Group II, n = 5: Each mouse received a daily topical dose of 62.5 mg IMQ cream on the shaved back skin for fourteen days. Group III, n = 5: Each mouse received a daily topical dose of 62.5 mg IMQ cream on the shaved back skin for fourteen days. On day seven after shaving and 4 hours after application of IMQ cream, each mouse in group III received 20 mg of Nigella sativa oil once daily for seven days. Skin specimens were obtained from the shaved parts of skin of the backs of all animals and were processed for light microscopic examination. Results Imiquimod (IMQ) application led to apparent increased epidermal thickness, apparent thickening of stratum corneum and alterations in the normal appearance of keratinocytes with vacuolation inside their cytoplasm and increased intracellular spaces between cells. Apparently Elongated epidermal rete ridges were observed along with abundant infiltrates of mononuclear inflammatory cells in the dermis. However, oral use of Nigella sativa oil (N.sativa) strongly inhibited IMQ-induced psoriasis-like inflammation and alleviated all epidermal and dermal changes observed after IMQ application. Conclusion N. sativa can be used as an effective treatment for modraete psoriasis.

Evaluation of Micro-Needling Followed by Tranexamic Acid Cream versus Micro-Needling Followed by Tranexamic Acid Solution in Treatment of Melasma: A Comparative Split Face Study

Abstract Background Melasma is a common pigmentary disorder clinically characterized by symmetric light brown to bluish-gray macules and patches with irregular, sharp borders that affect cutaneous areas, particularly the face and neck. It is commonly identified in women of reproductive ages and more commonly described in darker-skinned patients with Fitzpatrick skin types IV to VI residing in high-intensity ultraviolet radiation worldwide. It causes significant cosmetic disfigurement, psychosocial stress, and embarrassment, affecting patients’ quality of life. Objectives To evaluate the efficacy and safety of microneedling followed by tranexamic acid (TXA) cream application versus microneedling followed by tranexamic acid solution in the treatment of facial melasma. Patients and Methods This prospective split-face comparative study included thirty female patients with different types of melasma, their ages ranged from 25 to 40 years. They were recruited from the Dermatology outpatient clinic of Ain Shams University Hospitals. All patients have been treated with TXA for 3 sessions; one session every month (the right side of the face was treated by microneedling followed by TXA 5 % cream while the left side of the face was treated by microneedling followed by TXA solution 5%). Additionally, the right side of the face was treated with TXA 5% cream, and the left side applied with placebo cream twice daily for 3 months. Assessment was done by Hemi Melasma Area and Severity Index score (Hemi -MASI), patients’ satisfaction score, clinical digital photography, dermoscopic examination and area percentage of melanin concentration assessed by histopathological examination. Results Our findings showed significant improvement in different types of melasma regarding Hemi MASI score, patients’ satisfaction score, and area percentage of melanin concentration assessed by histopathological examination by Fontana-Masson stain (FM) one month after 3rd treatment session in both sides of the face. However, a minor melasma recurrence was observed two months after 3rd treatment session on both sides of the face. Meanwhile, no significant difference was observed in the treatment response of microneedling followed by TXA cream versus microneedling followed by TXA solution one month after 1st and 2nd sessions regarding Hemi MASI score, while a significant difference was observed one month after the 3rd session. Conclusion Topical TXA appears to be a promising therapeutic option in the treatment of melasma without serious adverse effects. Topical TXA cream, which was applied twice daily by the patient combined with microneedling sessions with TXA cream, has better results in comparison with microneedling sessions with TXA solution with placebo cream.

Application of Nimbadi Ointment after Chhedankarma in the Management of Gudavidradhi-A Case Study

Phenomena of vidradhi formation is due to vitiation of dosha resides in asthi and spreads and vitiates to the twacha, rakta, mamsa, meda and gradually reformed into excessively severe inflammatory swelling, which is maha-mulam (deep rooted), rujavantam (severe painful) vruttam (round) or aayatam (elongated in shape) that is calledvidhradhi1. In case of pei-anal abscess, originates from an infection arising in the crypto glandular epithelium lin-ing of the anal canal spreading into adjacent space and resulting in fistulas 40% of cases. Sheegravidahitvat definition of Vidradhi means virulence of disease. Acharya Sushruta mentions that if vidradhi attains pakvaavastha, the first line of treatment is to drain the pus through bhedana and later, it should be treated as Vrana. In the present context, a 52 years old male suffering from left sided gluteal abscess was admitted and treated with surgical incision and drainage This case ofanal abscess (gudavidradhi) so,application of nimbadi ointment after bhedankarma (incision and drainage) is the line of treatment.&#x0D;

A randomized prospective study to assess the role of topical tacrolimus as preventive therapy in unstable acral vitiligo.

Acral vitiligo is a significantly distressing condition and tends to be treatment-resistant. The occurrence of new lesions on acral areas further causes greater psychological trauma. Topical tacrolimus has been widely used in the management of vitiligo and its role in preventing flares in other dermatoses such as atopic dermatitis has been well documented. To assess the role of topical tacrolimus as preventive therapy in unstable acral vitiligo. In this single-center randomized prospective study, 60 patients aged 16-60 years having unstable acral vitiligo with symmetrical lesions were enrolled and randomized (1:1) into two groups. Patients in group A were instructed to apply topical tacrolimus 0.1% ointment on both vitiliginous and normal skin while patients in group B were instructed to apply topical tacrolimus 0.1% ointment only on vitiliginous skin for 6-months. Only the distal hand till the wrist joint was chosen for observation. Vitiliginous patches were assessed monthly for 6 months for a change in the number of lesions and total area involved, extension of preexisting lesions, and adverse effects if any. A reduction in the number of lesions was observed in both groups. The decrease in the number of lesions in group A was 5.6% as compared to 2.3% in group B (p-0.001). The decrease in depigmented area in group A was 10.5% as compared to 4.6% in group B (p-0.048). Treatment failure was seen in 11/60 (18.3%) patients. Tacrolimus 0.1% ointment application showed effectiveness in preventing the appearance of new lesions in unstable acral vitiligo and hastening the repigmentation when applied on both lesional and perilesional skin in vitiligo.