Dermatology Clinic Research Articles

Psoriasis in Childbearing Age: A Real-Life, Retrospective, Single-Center Study on Anti-IL17 and IL-23 Agents.

Background: Psoriasis (PSO) involves about 1-3% of the population, and around 75% of women develop PSO before the age of 40. Official guidelines on the treatment of woman with anti-IL17 and anti-IL23 during this potential childbearing time are not currently available. Objective: To investigate the effectiveness and safety of biologic treatments in women of childbearing age. Methods: At the Dermatology Clinic of the University of Turin, Italy, 172 women aged 20-55 years underwent IL-17 and IL-23 inhibitor therapy for moderate-severe PSO and were followed up to 52 weeks in a real-life, retrospective, single-center study. Results: Overall, 40% of patients achieved PASI 100 at week 16, and 72% at week 52. A similar trend was observed for PASI 90 and PASI < 3 with almost 80% and 90% of patients achieving the target at 52 weeks. As for PASI 100, a statistically significant difference (p = 0.004) was found at 16 weeks, with 23.84% of patients achieving PASI 100, with IL-17 and 15.70% with the IL-23 inhibitor. No statistically significant differences were found at 28 and 52 weeks. No statistically significant differences in PASIs at any time points were recorded across the different biologic agents. Forty-six patients discontinued treatment. The most reported side effects were headache, nausea, asthenia, injection site pain, and rhinitis. Conclusions: This study showed that biologic drugs are effective and safe in women of childbearing age, with negligible side effects.

Different Pathways of Skin Aging: Objective Instrumental Evaluation.

Background/Objectives: Hypertrophic and atrophic skin aging represent two distinct phenotypes: hypertrophic aging is marked by deep wrinkles and a leathery texture, whereas atrophic aging is characterized by overall skin thinning, increased vascularity, and a higher risk of non-melanoma skin cancers. This study aims to elucidate the characteristics and differences between hypertrophic and atrophic facial aging subtypes using two non-invasive imaging devices: VISIA® and dynamic optical coherence tomography (D-OCT). Methods: We retrospectively evaluated patients who had presented to the outpatient dermatological clinic at Policlinico Umberto I hospital in Rome, Italy for a non-invasive facial imaging check-up. We included 40 patients aged 60-75 who were imaged with VISIA® and dynamic optical coherence tomography (D-OCT). Based on the number of UV spots and amount of red found on VISIA®, subjects were grouped into four subgroups (PIGM, RED, CONTROL, PIGM + RED), and trends among them were analyzed. Results: We found a strong correlation between VISIA® red area scores and D-OCT vascular density at 300 µm depth, confirming VISIA®'s effectiveness for assessing facial vascularity. Wrinkle count was highest in areas with UV spots, particularly in the PIGM and PIGM + RED groups. Conversely, low attenuation coefficients and dermal density were observed in regions with low UV spots but high red areas. Intermediate subgroups (CONTROL and PIGM + RED) displayed varying parameters. Conclusions: Non-invasive imaging devices are effective in evaluating facial aging and distinguishing between aging subtypes. This study identified two intermediate aging types in addition to the hypertrophic and atrophic subtypes.

Psychiatric Symptoms in Patients with Immune-Related Mucocutaneous Lichen Planus

Background: Lichen planus (LP) is one of the most common chronic mucocutaneous diseases with an underlying immunological component. Although the pathogenesis of this condition is not exactly known, numerous studies have been conducted due to the significance of this disease and its high prevalence. Several risk factors and various contexts have been identified for this condition; however, the primary cause is still not fully understood. Some genetic and environmental factors may be involved in the development of the disease. The present study was conducted to examine psychiatric symptoms in patients with cutaneous-oral LP (COLP) referred to the dermatology clinic of Sina Hospital of Tabriz city, northwest of Iran. Methods: This descriptive study was conducted on 31 patients with LP and 31 healthy individuals referred to the dermatology clinic of Sina Hospital in Tabriz. The information required was collected using the SCL-90-R standard questionnaire, and the data were analyzed using descriptive and inferential statistics with the help of SPSS v.23 and multivariate analysis of variance (MANOVA). Results: The results showed that people with COLP do not suffer from serious psychiatric conditions but may have merely mild to moderate psychiatric symptoms. However, the MANOVA test indicated that the symptoms had a significantly higher incidence in patients with oral LP compared to matched control subjects (F (12,47)=13.86, P&lt;0.05). Conclusion: As shown by the SCL-90-R standard checklist, patients with oral LP expressed significantly more psychiatric symptoms than normal individuals, reflecting the need for these patients for more regular assessments.

CK20-negative Merkel Cell Carcinoma with Concomitant Squamous Cell Carcinoma In-Situ and Metastasis to the Parotid Gland

Abstract Introduction/Objective This report presents a patient with an aggressive CK20-negative neuroendocrine tumor of the dermis with metastasis to the parotid gland and a concomitant squamous cell carcinoma in-situ (SCCIS) and highlights diagnostic challenges of CK20-negative tumors. Methods/Case Report A centennial female with a history of non-melanoma skin cancer and leukemia presented to the dermatology clinic with a one-year history of an enlarging skin lesion on her right cheek and a subcutaneous mass on the right central lateral neck. On examination, the lesion appeared as a rough and raised red papule with a central crust. On CT, a large heterogeneously enhancing right parotid mass with surrounding satellite nodules, adjacent necrotic adenopathy, and an ulcerating subcutaneous mass in the adjacent right face. An incidental 3 mm right upper lobe nodule was identified. The pathology report noted two distinct malignant neoplasms within the specimen. Microscopy revealed ulceration with acanthosis and full thickness keratinocyte atypia, suggesting Bowen’s disease. On microscopic examination of the separate dermal tumor, there were sheets of uniform small cells with a high nuclear to cytoplasmic ratio and scant cytoplasm. IHC staining was positive for the neuroendocrine markers AE1/AE3, CAM5.2, synaptophysin, and CD56. CK20, CK7, and TTF-1 were negative. As some MCC may be negative for CK20, CK20 was performed twice. Differential diagnoses included SCCIS with CK20-negative MCC versus a metastatic neuroendocrine carcinoma of parotid gland to the skin. The patient transitioned to hospice care soon after the diagnosis. Results (if a Case Study enter NA) NA. Conclusion Our patient presents with an interesting case of a CK20-negative MCC with metastasis to the parotid gland. Since CK20 was stained negative twice, it complicated the diagnosis of MCC vs. small cell carcinoma. We suspected a more likely diagnosis of MCC metastasis to the parotid gland due to multiple reported cases (Day et al. 2016). Our patient also had an identifiable Bowen’s disease borderline to the neuroendocrine carcinoma. It is well known of the coexistence of MCC and squamous cell carcinoma in a cutaneous lesion (Suaiti et al. 2019). Thus, a metastatic MCC to the parotid gland is more likely in this case. As MCC is an aggressive cancer that metastasizes quickly, accurate diagnosis is crucial. With recent literature reporting the association of CK20-negativity with VN-MCC, and the presence of UV signature mutations in CK20- negative MCC, genomic screening would be a useful diagnostic tool.

The Relationship Between Body Dysmorphic Disorder and Depressive Symptoms with Health-Related Quality of Life in Women with Vitiligo

Background: Vitiligo is a common skin disorder characterized by the loss of skin pigment, which can significantly impact individuals' health-related quality of life (HRQoL), particularly in women. Body dysmorphic disorder (BDD) and depressive symptoms are common psychological comorbidities associated with vitiligo. Objectives: This study aimed to investigate the relationship between BDD, depressive symptoms, and HRQoL in women with vitiligo. Methods: A cross-sectional study was conducted in Ahvaz, Iran, in 2023, involving a sample of 152 women with vitiligo. The study population included all women with vitiligo who presented to dermatology or cosmetic clinics in Ahvaz during that year. Data were collected using the MOS 36-item Short-Form Health Survey (SF-36), the Multidimensional Body-Self Relations Questionnaire (MBSRQ), and the Beck Depression Inventory (BDI). Pearson's correlation and regression analyses were used to assess the relationships between variables. Data analysis was conducted using SPSS-27 software. Results: Women with vitiligo had a mean health-related quality of life score of (58.13 ± 11.50). Their mean score on the body dysmorphic disorder assessment was (99.61 ± 37.33), and the mean depressive symptom score was (20.25 ± 4.47). Significant negative correlations were found between BDD and HRQoL, as well as between depressive symptoms and HRQoL, in women with vitiligo (P &lt; 0.001). Multiple regression analysis showed that BDD and depressive symptoms independently predicted HRQoL (P &lt; 0.001). Conclusions: Body dysmorphic disorder and depressive symptoms are significantly associated with impaired HRQoL in women with vitiligo. Screening for and treating BDD and depressive symptoms may improve HRQoL in this population.

Teledermatology: an evidence map of systematic reviews

BackgroundAlthough the number of teledermatology studies is increasing, not all variables have been researched in equal depth, so there remains a lack of robust evidence for some teledermatology initiatives. This review describes the landscape of teledermatology research and identifies knowledge gaps and research needs. This evidence map can be used to inform clinicians about the current knowledge about teledermatology and guide researchers for future studies.MethodsOur evidence map was conducted according to the Campbell Collaboration checklist for evidence and gap maps. Eight databases were searched (CINAHL, Embase, PubMed, Scopus, Web of Science, Cochrane Library, JBI Database of Systematic Reviews and Implementation Reports, and OpenGray), and only included systematic reviews of teledermatology involving humans published in English; while excluding non-systematic reviews (i.e., abstracts, conference proceedings, editorials, commentaries, or letters). From 909 records, 14 systematic reviews published between 2004 and 2022 were included. Our analysis focused on the systematic reviews’ characteristics, dermatological conditions studied, rate of overlap and quality assessment of primary studies reviewed, and main findings reported.ResultsTeledermatology was reportedly comparable with clinic dermatology and generally accepted by patients as a mode of care delivery for dermatological conditions. However, there are concerns about privacy, communication, completeness of information transmitted, familiarity with the technology, and technical problems. Healthcare professionals were generally satisfied with teledermatology but found telemedicine consultations longer than face-to-face consultations, and less confident in asynchronous teledermatology than conventional consultations. Teledermatology was reportedly more cost-effective than clinic dermatology; especially considering the distance traveled by patients, referral volume to teledermatology, and clinic dermatology costs. Although patients and providers are satisfied with teledermatology, face-to-face dermatology has higher diagnostic and management accuracy. Teledermatology was also used for training medical professionals. Regarding the validity and reliability of teledermatology outcome measures, no significant discussions were found.ConclusionsCOVID-19 spotlighted telemedicine in clinical care, and we must ensure telemedicine continually improves with robust research. Further research is necessary for establishing a standardized outcome set, enhancing accuracy, concordance, cost-effectiveness, and safety, comparing teledermatology with non-dermatologist care, examining its effectiveness in non-Western low and middle-income countries, and incorporating patient involvement for improved study design.Systematic review registrationhttps://www.researchregistry.com/ (Unique Identifying Number: reviewregistry878).

Regulated Medical Waste Reduction in the Dermatology Clinic.

The disposal of regulated medical waste (RMW) in the healthcare setting can be both costly and environmentally harmful. Prior studies have found large amounts of waste disposed of in RMW containers are inappropriately placed. Few studies to date have investigated the efficacy of waste reduction practices in the dermatology setting. This study aims to evaluate the effectiveness of a practice-wide intervention in reducing RMW in the outpatient dermatology setting. By performing daily waste audits and two concurrent educational interventions, the amount of RMW produced and percent of appropriately placed RMW will be measured. Further analysis will occur by comparing pre-intervention values to post-intervention values. The percentage of waste properly placed in RMW containers prior to any intervention was 11%. Following both educational interventions, the percentage of waste properly placed in RMW containers increased by 56.1% (CI 43.7-68.5%) and the percentage of total waste produced that was identified and disposed of as RMW decreased by 6.0% (95% CI 1.2-10.8%). Our study provides practical data for dermatology providers to make small changes which can result in significant reductions of regulated medical waste, potentially providing benefits to the environment and cost-savings.

Effects of the COVID-19 pandemic on inpatient dermatosurgery in Germany : Retrospective evaluation of the surgical cases from nine dermatology clinics

Currently, only little data is available on the impact of the COVID-19 pandemic on inpatient dermatosurgical care in German dermatological clinics. Aretrospective analysis of all dermatosurgical cases that were treated in inpatient setting in nine German dermatological clinics in four federal states in 2019, 2020 and 2021 was performed. The diagnoses were recorded using the ICD-10codes. In addition, demographic data such as age, gender and the length of inpatient stay were analysed. In 2019, 2020 and 2021, a total of 10,739, 9185 and 9828 dermatosurgical inpatients were treated respectively. Thus, the reduction of inpatient dermatosurgical cases was 14.5% in 2020 and 8.5% in 2021 compared to 2019. Inpatient surgical treatment of melanoma decreased by 10.1% of cases in 2020. This decrease was only 1.4% in 2021 compared to 2019. The number of inpatient surgeries performed for benign lesions such as melanocytic nevi or viral warts reduced sharply in both pandemic years. Our data show for the first time how inpatient care for the entire spectrum of dermatosurgical diseases developed during the COVID-19 pandemic in Germany. After the initial marked decline in inpatient dermatosurgical cases in 2020, there was less difference in 2021 compared to 2019. This trend can be interpreted as an indication that there is still astrong need for inpatient dermatosurgical care that cannot yet be met on an outpatient basis.

Frequency of cutaneous drug reactions in the outpatient dermatology clinic at the National Institute of Cardiology Ignacio Chávez over a ten-year period

Cutaneous adverse drug reactions, or pharmacodermias, are the most common form of adverse drug reactions (ADR). It was our interest to know their epidemiological behavior in a tertiary hospital level in Mexico. We stablished the frequency of ADR in 61 infants and adults hospitalized patients and those seen in the outpatient Dermatology Clinic at the National Institute of Cardiology Ignacio Chávez in Mexico City (INCICh) over a period of 10 years. The most frequently diagnosed pharmacodermias were acneiform dermatitis, cutaneous hyperpigmentation and maculopapular exanthema mainly associated to prednisone, hydroxychloroquine, cephalothin, amiodarone and vitamin B-complex, although we registered less frequently more severe and hazardous reactions. These results were consistent with other reports in our country. Multiple drugs administered at a time was an important causative factor for the ADR. It is necessary for every practitioner to develop skills that permit the identification of these dermatoses in order to correctly manage each case and diminish the morbimortality associated.

Development and evaluation of an online training tool to aid in the diagnosis of chronic plaque psoriasis

AbstractBackgroundChronic plaque psoriasis (CPP) is underdiagnosed, undertreated and mistaken for other skin conditions such as eczema, tinea corporis and pityriasis rosea.ObjectivesTo develop and evaluate an online training tool to improve the diagnostic skills of nondermatologists for CPP.MethodsThe study involved: (i) developing an online training tool to improve CPP diagnosis by nondermatologists; and (ii) evaluating the performance of the newly developed training tool by conducting a before‐and‐after exploratory investigation. Participants included three groups of primary care health professionals: general practitioners (GPs); nurses; and pharmacists. The tool contained written recommendations for the diagnosis of CPP in different skin colours and a medical artist's illustrations of psoriasis to overcome the lack of representative images of the disease in skin of colour and to illustrate the salient features more clearly than clinical photographs.ResultsIn total, 60 participants completed the study (20 per participant group). The training tool improved participants' diagnostic skills for CPP. The diagnostic ability of GPs was, on average, higher than nurses and pharmacists before and after training. Participants found the training valuable and relevant to CPP diagnosis in primary care settings.ConclusionsOur findings show that a training tool, using medical illustrations, for nondermatologists can be beneficial in terms of recognition of CPP. This may lead to more timely diagnosis and treatment of psoriasis and support relevant and faster referral to specialist dermatology clinics.

Sun exposure and challenges of sun protection in adolescents and young adults: A prevalence observational study.

The present study aimed to explore the adherence to and efficiency of skin protection measures among teenagers and young adults. The present study investigated the reasons for sun exposure and the obstacles impeding sun protection. In the summer of 2023, a self-reported questionnaire was posted on the social media account of two high schools, a university, some industrial companies and among the teenage children of a dermatology clinic. Descriptive statistics and multivariate logistic regression analyses were performed to assess the reasons for sun exposure behavior, sun protection measures and the frequency of sunburn among individuals aged 15 to 25 year. A total of 517 young individuals completed the questionnaire. It was found that 43.5% use a hat as a means of sun protection, and only 10% try to limit their exposure to the sun. Nevertheless, 78.7% indicate the use of sun cream, 61.7% expose themselves frequently or very frequently to the sun, and 51.2% exposed themselves to the sun for tanning. Young females were statistically more prone to tan [odds ratio (OR), 2.95; 95% confidence interval (CI), 1.95-4.46] P=0.03 than males. Males exposed themselves to a 3-fold greater extent during recreational activities (OR, 2.98; 95% CI, 1.56-5.69) P=0,025, compared to females. On the whole, the present study demonstrates that young individuals aged 15 to 25 years are exposing themselves too frequently to the sun. A large proportion of individuals still wishes to acquire a tan. Even if the large majority of individuals uses sunscreen, the majority of these do not protect themselves correctly since they report becoming sunburnt frequently.

Clinico-epidemiological profile of dermatology patients: a one-year study at a newly established tertiary care centre in India

Background: Dermatology is predominantly an outpatient specialty focused on the diagnosis and treatment of dermatoses affecting the skin. We conducted a study on the demographic and clinical characteristics of patients attending the outpatient clinic to better understand the clinico-epidemiological profile and to predict morbidity patterns within the specific geographical region. Methods: A retrospective study was conducted over the past year, encompassing all patients who visited the outpatient dermatology clinic at AIIMS, Raebareli. The study systematically documented a range of dermatoses, including disorders affecting the skin, hair, and nails. Results: A total of 4,188 patients were included in the study, comprising 2,681 (64%) adults, 978 (23.4%) geriatric patients, and 529 (12.6%) pediatric patients. Among these, 1,311 patients primarily suffered from infections, followed by 752 patients with dermatitis. Of those with infections, 1,024 (78%) were diagnosed with fungal infections, while scabies was observed in 126 patients (9.6%). In the adult group, 756 (28.2%) patients had infections, while 429 (16%) patients were affected by dermatitis. Similar patterns were observed in both the geriatric and pediatric groups, with infections being the most prevalent, affecting 214 and 341 patients, respectively. Conclusions: Based on the findings of this study, it can be concluded that infections, particularly fungal infections, are the most prevalent dermatological conditions across all age groups in the population studied. Dermatitis also emerged as a significant concern, particularly among adult patients. The high prevalence of infectious dermatoses, especially in geriatric and pediatric patients, highlights the need for targeted public health interventions and preventive measures.

Parasitological prevalence of scabies and secondary bacterial infections among scabies suspected patients at Borumeda General Hospital, Northeast Ethiopia

BackgroundScabies disproportionately affects people in resource-poor areas. Clinical diagnosis risks misdiagnosis due to resemblance to other skin diseases, but laboratory confirmation improves accuracy. Scabies allow for secondary bacterial infections. Associated bacteria exacerbate scabies and antibiotic resistance. Ethiopian scabies diagnosis relies solely on clinical exams without confirming parasites or investigating secondary bacterial infections. This study aims to identify parasites via scraping, isolate secondary bacteria, and evaluate their antibiotic susceptibility profiles.MethodsA hospital based cross-sectional study was conducted from September 2022 to July 2023 among scabies suspected patients who visited the dermatology clinic at Borumeda General Hospital in Northeast Ethiopia. A systematic random sampling technique was used to select 422 study participants. Socio-demographic, hygiene, and clinical characteristics data were collected via face-to-face interviews and observation. Skin scrapings for parasitological investigations and swab samples for microbiological investigations were collected and transported for analysis and drug susceptibility testing. Descriptive statistics and logistic regression analysis were employed to assess risk factors.ResultAmong 422 skin scraping samples, 156 (37.0%) cases of scabies were microscopically confirmed. Bed-sharing and having contact history were independent predictors of microscopically confirmed scabies. The prevalence of secondary bacterial infections among scabies-confirmed patients was 35.9% (56/156). The most prevalent bacterial species were Staphylococcus aureus, coagulase-negative staphylococci, and Streptococcus pyogenes. Tetracycline for Gram-positive bacteria and ampicillin for Gram-negative bacteria showed the highest rate of resistance. In both Gram-positive and Gram-negative strains, multidrug resistance was also observed.ConclusionThis study found that over one-third of skin scrapings tested positive for scabies. Additionally, more than one-third of scabies cases were complicated by secondary bacterial infections. Improved scabies diagnosis and consideration of secondary bacterial infections are important for better controlling this neglected tropical disease.

Mental health among parents and their children with eczema in Hong Kong.

This cross-sectional survey research investigated mental health symptoms and quality of life among Chinese parents and their children with eczema at a paediatric dermatology clinic in Hong Kong from November 2018 to October 2020. Health-related quality of life, eczema severity, and mental health among children with eczema, as well as their parents' mental health, were studied using the Children's Dermatology Life Quality Index (CDLQI), Infants' Dermatitis Quality of Life Index (IDQOL), Nottingham Eczema Severity Score (NESS), Patient-Oriented Eczema Measure (POEM), and the Chinese version of the 21-item Depression, Anxiety, and Stress Scales (DASS-21). In total, 432 children and 380 parents were recruited. Eczema severity (NESS and POEM) and health-related quality of life (CDLQI) were significantly positively associated with parental and child depression, anxiety, and stress levels according to the DASS-21, regardless of sex (children: r=0.28- 0.72, P<0.001 to 0.007; parents: r=0.20-0.52, P<0.001 to 0.034). Maternal depression was marginally positively associated with increased anxiety in boys with eczema (r=0.311; P=0.045). Younger parents had higher risk of developing more anxiety and stress compared with the older parents (adjusted odds ratio [aOR]=-0.342, P=0.014 and aOR=-0.395, P=0.019, respectively). Depression level of parents with primary to secondary education was 58% higher than their counterparts with post-secondary education or above (aOR=-1.579; P=0.007). Depression, anxiety, and stress among children with eczema and their parents were associated with eczema severity and impaired quality of life in those children. These findings regarding impaired mental health in children with eczema and their parents highlight the need to include mental well-being and psychosocial outcomes in future studies and clinical practice.

A Showcase Presentation Honoring the Editorial Board of Clinics in Dermatology

For over forty years, the Editorial Board of Clinics in Dermatology has been working behind the scenes to help our Editor-in Chief, Dr. Lawrence Parish, bring to readers the best contributions in dermatology. Herein, we tell the story of the beginnings of Clinics in Dermatology and provide a list of the inaugural board members of which we highlight four: Drs. Jean Civatte, John Thorne Crissey, Francisco Kerdal-Vegas, and Joseph A. Witkowski. In addition we showcase our present 44 Editorial Board members including our Managing Editor Dr. Hirak Behari Routh,our Senior Deputy Editors Dr. Larry E. Millikan, and Dr. Marcia Ramos-e-Silva, and our esteemed Chief Editor Dr. Lawrence Charles Parish and Chief Editor Designate, Dr. Vinod E. Nambudiri. We are proud that all our Editorial Board members come with stellaracademic achievements in dermatology and from all over the world. We are an active Editorial Board, who work together, issue after issue, to provide the best in peer review contributions and theme issues. We look forward to continuing in this role for many years to come and weare grateful to our current publisher, Elsevier, and to our many authors, and dear readers for their ongoing support and encouragement.

40 Years of Clinics in Dermatology

In 2023, Clinics in Dermatology marked its 40th anniversary, celebrating a remarkable journey of excellence since its inception in 1983. Still, led by its founding editor, Lawrence Charles Parish, the journal has consistently delivered cutting-edge research and clinical insights, becoming a cornerstone resource in dermatology. The journal has published 3667 documents. In all publications, 4,311 authors from 4,248 departments and 78 countries played a pivotal role. We provided data about the total number of publications and citations for each contributor (author, department, and country). By co-word analysis, we presented the central theme of publications, which may offer a nuanced understanding of Clinics in Dermatology's diverse and influential contributions to dermatological science.

Patient perspectives towards skin of color clinics: results from a survey study.

Skin of color clinics (SOCCs) are dermatology clinics that provide specialized care for patients with melanated skin. Little is known about patient perceptions and attitudes toward these clinics. We sought to perform a survey study to assess the opinions of patients of color previously seen in our dermatology department toward SOCC. A 14-question survey was sent by email to patients of color seen at our institution between January 1, 2015 and December 31, 2021. Out of 264 participants who completed the survey, 176 (66.7%) indicated they would prefer to be seen in a SOCC and 88 (33.3%) preferred to be seen in a general dermatology clinic (GDC). Clinic choice varied significantly by ethnicity, with Black/African American participants being the most likely to prefer SOCC over GDC than other races/ethnicities. Those interested in SOCC were primarily motivated by a search for expertise in the skin of color (SOC) and did not have a preference for the skin color of the SOCC dermatologist. Those interested in GDC were happy with their current care. This study was limited by the single-center design and sample bias. Our results overall provide positive patient feedback for the creation of SOCCs as centers for expertise in SOC. The preference for SOCC varied by race/ethnicity, highlighting that clinic choice is best left to the patient.

Calvarial Thickening in Tuberous Sclerosis Complex

IntroductionTuberous sclerosis complex (TSC)-related skeletal abnormalities are under-studied. Awareness of skull thickening in TSC patient is important from the surgical standpoint because thick skull might complicate craniotomy. This study, aimed at revealing if TSC patients are generally prone to skull thickening, had led us to retrospectively investigate the frequency and characteristics of skull thickening in these patients. MethodTSC patients aged 10 to 60 years who underwent MRI were identified from the neurosurgery, dermatology or pediatrics clinic between 2010 and 2021. Two control groups were used for comparison: one with unruptured intracranial aneurysms to serve as control without anti-seizure medications (ASMs) exposure and another with non-TSC epilepsy as control with ASM exposure. Thickness of frontal, parietal, temporal, and occipital bones was measured at a fixed location of each bone across patients on T2-weighted axial images. Result29 patients fulfilled the inclusion criteria. Frontal and temporal bones of the TSC group were significantly thicker than those of either control group. Skull thickening was significantly associated with intracerebral calcification, but not with age, sex, or ASM exposure. Focal skull thickening was associated with the presence of a subcortical calcification. ConclusionsTSC patients have thickened skull that is often linked to intracerebral calcification. The presence of skull thickening may require modification of surgical approach during craniotomy. Skull thickening and the underlying intracerebral calcification likely share a common precipitating factor given their relationship. Future studies are warranted to clarify the genetic underpinnings of this relationship and even broader skeletal abnormalities in TSC.

Low Serum Vitamin E Levels Positively Correlate with the Severity of Acne Vulgaris

ABSTRACT Acne vulgaris (AV) is a common disorder of the pilosebaceous, especially prevalent in adolescents. Acne vulgaris ranks among the top ten most prevalent diseases globally. Although AV may resolve spontaneously, sequelae such as scar formation can persist, causing aesthetic and psychological disturbances. There is an antioxidant to counteract acne-causing oxidative stress, vitamin E, which is an important antioxidant in the human body. Therefore, vitamin E in the skin can reduce the formation of squalene peroxide and prevent the occurrence of AV. This is an analytical observational study using a cross-sectional design. The investigation was conducted at the Dermatology and Venereology Clinic of Prof. Dr. I.G.N.G. Ngoerah Denpasar Hospital and the laboratory of the Faculty of Medicine, Udayana University, from February 2024 until the sample size was fulfilled. The sample consisted of patients aged 12-45 years with acne vulgaris who visited the clinic and were then selected through consecutive sampling according to the inclusion and exclusion criteria. In the non-AV group, the mean serum vitamin E level was 19.3 ± 0.99 µg/ml, whereas in the AV group, it was 4.49 ± 19.1 µg/ml, indicating a significant variance. There was a positive correlation between low vitamin E levels and the severity of AV. The linearity graph shows the direction of the relationship between serum vitamin E levels and the severity of AV, which leads to the lower right, indicating that the higher the severity of AV, the lower the serum vitamin E levels. The mean levels differed significantly between the non-AV and AV groups. A favorable association was found between low vitamin E levels and the severity of AV. Keywords: Acne Vulgaris, Severity, Serum Vitamin E, Reactive Oxygen Species (ROS)

Psychological Profile of Patients Presenting with Dermatological Complaints: A Cross-sectional Study

Objectives: The study evaluates the psychological profile in patients presenting to a dermatological clinic in Mumbai, India. Materials and Methods: We evaluated anxiety, depression, stress, anger, body image, and relationships in 63 outpatients presenting with dermatological complaints. We used linear regression models for multivariate analyses for coefficient and 95% confidence intervals (CIs). Results: The mean age (standard deviation [SD]) was 37.4 (14.9) years; 30 (51%) were female and 31 (49%) were male. The common diagnoses were papulosquamous conditions (24%), acne (18%), hair fall (15%), pigmentary conditions (11%), pruritus (10%), and infection (8%). The mean anxiety (SD) score was highest in pigmentary conditions (11.6 [13.9]), depression (15.0 [5.0]) and posttraumatic stress scores (16.3 [25.6]) in pigmentary conditions, social phobia scores in allergy (21.8 [17.0]), and anger scores in acne (25.4 [6.3]). The mean (SD) family scores were lowest in pruritus (8.0 4.2]), body image in infection (3.6 [0.9]), and self-image in pigmentation (6.0 [2.3]). The mean social phobia scores were higher in allergy compared with acne (12.2, 95% CI: 1.6, 22.8, P = 0.02). Body image scores were lower in pruritus (−7.7, 95% CI: −14.5, −0.9, P = 0.03). Conclusion: The psychological parameters differ in various dermatological conditions; hence, a complete profile analysis will be beneficial for designing interventions in these patients.