Common Dermatoses Research Articles

Оценка экономического бремени псориаза в республике Башкортостан

Psoriasis is one of the most common chronic dermatoses, leading to disability of patients. The damage from it is comparable to the damage from atrial fibrillation, lung cancer, breast cancer. P u r p o s e of our study was to determine the economic burden of psoriasis in the Republic of Bashkortostan, depending on the volume of costs for different treatment options. M a t e r i a l s a n d m e t h o d s . The paper calculates the economic burden of psoriasis in the Republic of Bashkortostan based on official data from the Medical Information and Analytical Center of the Republic of Belarus, the Territorial Compulsory Medical Insurance Fund of the Republic of Belarus and Bashkortostanstat for the period 2020-2021. R e s u l t s . There is increase in the number of patients with psoriasis in the Republic of Bashkortostan for the period 2012-2021. The total economic burden of psoriasis in the Republic of Bashkortostan is 896970909,00 rubles in year (66055,7 rubles per patient), including: for all types of treatment, taking into account the funds of the patients themselves, 559028692,5 rubles are spent, for temporary disability benefits 300293897,6 rubles, disability benefits 37648318,9 rubles. The largest proportion of patients regularly treated for psoriasis are patients receiving therapy both in a hospital and in a polyclinic (42,1%). The allocated volumes of high-tech medical care, as well as genetically engineered biological therapy in the Republic of Bashkortostan are insufficient to provide all patients in need with these types of assistance. One third of patients with psoriasis (33,6%) do not seek treatment from dermatovenereologists. C o n c l u s i o n . The results obtained indicate the need for further detailed study of the issue of economic costs associated with the prevalence of psoriasis in the Republic of Bashkortostan, the development of measures to reduce the incidence of the population, risk factors and relevant policy documents for the resource provision of medical care for patients. The medical, social and economic efficiency of the measures will be expressed by improving the quality of life of patients, reducing the economic damage from temporary disability and disability.

The effect of baseline eczema or psoriasis on the morphology of cutaneous immune-related adverse events due to immune checkpoint inhibitor therapy

To the Editor: Inflammatory skin reactions have been associated with immune checkpoint inhibitors.1 These cutaneous immune-related adverse events (cirAE) encompass common dermatoses including eczema and psoriasis, as well as lichenoid, maculopapular, and immunobullous eruptions.1 Although identification of risk factors for specific cirAE could potentially improve outcomes, research on the association of dermatologic history and morphologic patterns of cirAE is lacking.2

Entzündliche Dermatosen auf pigmentierter Haut

Acne, rosacea, atopic dermatitis, and psoriasis vulgaris are common inflammatory dermatoses. Of note, the epidemiology and clinical presentation of these common dermatologic diseases varies considerably between people with different colors of skin. Yet, most dermatology textbooks present and describe the clinical pictures of White people. To provide excellent dermatological care for all patients, it is of central importance to know the epidemiology and recognize key clinical characteristics of these diseases in patients with skin of color (SOC). In acne, cultural habits of Blacks (use of steroid-based lighteners, comedogenic hair care products) may lead to manifestation of specific forms of acne. In addition, postinflammatory hyperpigmentation and keloids pose particular therapeutic challenges in this patient group. Atopic dermatitis in Asians shows aclinical and histological picture that is similar to psoriasis in Whites. By contrast, atopic dermatitis manifests on the extensor side in Black people. Due to the difficulty of recognizing erythema in SOC, the severity of the respective inflammatory diseases in these individuals is often underestimated. The treatment of acne, rosacea, atopic dermatitis, and psoriasis does not differ between people of different skin colors. The exception is the necessary therapy for postinflammatory hyperpigmentation in all the inflammatory dermatoses mentioned, and for keloids in acne.

Dermoscopic Features and Their Diagnostic Values Among Common Inflammatory and Infectious Dermatoses: A Cross-Sectional Study

Dermoscopy is a non-invasive tool widely used to improve the diagnostic accuracy of general dermatological conditions. To determine the dermoscopic features and their diagnostic value in distinguishing common inflammatory and infectious dermatoses. A cross-sectional study was conducted on patients clinically diagnosed with common inflammatory or infectious skin diseases. Baseline characteristics and clinical and dermoscopic findings were recorded. Dermoscopic variables were analyzed using a correlation matrix. A skin biopsy was performed for each patient for a definitive diagnosis. Of 102 patients, 43 with dermatitis, 30 with psoriasis, 14 with lichen planus (LP), 5 with pityriasis rosea (PR), and 10 with others were included. Dull red background, patchy vessels, and scales showed significant positive correlations with dermatitis (r = 0.401, 0.488, and 0.327, respectively; p < 0.01), whereas bright red background, glomerular vessels, regular vascular distribution, and diffuse scales revealed significant positive correlations with psoriasis (r = 0.412, 0.266, 0.798, and 0.401, respectively; p < 0.01). For LP, whitish reticulate structures, purplish background, and dotted vessels mixed with linear vessels in the peripheral distribution were significantly positively correlated (r = 0.831, 0.771, 0.224, and 0.558, respectively; p < 0.05). Yellowish background and peripheral scales were predictive of PR diagnosis (r = 0.254 and 0.583, respectively; p < 0.01). Dermoscopy can be used as an adjunctive tool to differentiate conditions among common inflammatory and infectious dermatoses in order to minimize unnecessary invasive diagnostic procedures.

Intradermal Platelet-Rich Plasma for the Treatment of Melasma: A Clinical and Dermoscopic Evaluation in Dark Skin.

Melasma is a common dermatosis in both men and women showing varying degrees of success with treatment. Relapse of melasma is high in dark skin types, which necessitates the need for finding a modality of treatment, which not only treats but also prevents relapse. To study the effectiveness of platelet-rich plasma (PRP) in patients of melasma both clinically and dermoscopically in dark skin types. A prospective study of 20 female patients of Fitzpatrick skin type IV-V with mixed type of melasma and bilateral involvement of the face were enrolled for the study. PRP was injected intradermally at 4 weeks interval for three sittings, and the results were assessed clinically (by modified melasma area and severity score) and dermoscopically. Patients were counselled to ensure strict sun protection measures. Patient satisfaction was noted at baseline, 4 weeks, 8 weeks, and 12 weeks. Patients were followed up for 3 months to see for any relapse of the pigmentation. The follow-up showed no relapse of melasma in these patients. Analysis of variance was used with Bonferroni correction for modified melasma area and severity score at various time interval. Subject global aesthetic improvement scale (SGAIS) and physician global esthetic improvement scale (PGAIS) were expressed in counts. P-value ≤ 0.05 was considered significant. Modified melasma area and severity score and dermoscopic changes showed statistically significant improvement compared at the end of study in mild to severe cases. The subjective assessment was made by PGAIS. Patient satisfaction levels (assessed by SGAIS) also showed significant improvement in successive weeks of treatment. Few patients had mild redness and burning post procedure, which resolved spontaneously after few hours. From this study we concluded that PRP shows a significant improvement in melasma after 12 weeks of treatment with no relapse even after 3 months. Hence, PRP may be used not only as an adjuvant but also as a first line treatment in the view of longer sustained results when combined with strict sun protection. There is a paucity of studies showing results of PRP treatment in dark skin types, which is more resistant to treatment than lighter skin. Moreover, clinical improvement should not be the only parameter to decide on stopping treatment as chances of relapse can be higher. Dermoscopic evaluation helps in determining the changes in vasculature (telangiectasias) and pigmentation (dots and globules), which are better indicators of success of treatment.

Pattern of Noninfectious Pediatric Dermatoses at a Tertiary Care Center in Gujarat

Introduction: Pediatric dermatoses are commonly encountered in the dermatology outpatient department with various presentations in the form of infective and noninfective dermatoses. The incidence and severity of these dermatoses are influenced by geographic, cultural, genetic factors and socioeconomic status. This study was planned to evaluate the burden and pattern of disease among children. Materials and Methods: This was an ambispective observational cohort study, and all the children &lt;12 years of age with noninfectious dermatoses were included from July 2020 to December 2020. Results: We included a total of 1206 pediatric patients in 0–12 years of age with dermatological complaints, of which noninfectious dermatoses were 53% (n = 639) and infectious dermatoses 47% (n = 567). Out of them, 340 (53%) were males and 299 (47%) were females. Among all noninfectious dermatoses, eczema (30%) was found to be the most common dermatosis in our study. Conclusion: The present study focused on noninfectious dermatoses and highlighted the fact that they form a considerable burden of pediatric dermatoses.

A study of pattern and assessment of life quality index in patients of nonvenereal dermatoses of external genitalia at a tertiary care center.

Nonvenereal dermatoses (NVD) are the spectrum of disorders involving the genitalia with varied etiology and having a considerable influence on the health-related quality of life (QOL), but it remains under evaluated. To study the prevalence, pattern, and the effect of nonvenereal genital dermatoses on the QOL of patients with the help of dermatological life quality index (DLQI) questionnaire. This was a cross-sectional study conducted for a period of 1 year. A total of 132 patients were included in the study. QOL was assessed by using the DLQI questionnaire. The prevalence was found to be 10.2/1000 cases in our study. Genital scabies (34.8%) was the common dermatoses followed by vitiligo (18.9%) and lichen simplex chronicus (8.3%). These dermatoses were having moderate effect on the DLQI of majority (52.3%) of the patients and its having very large effect on DLQI in 20.5% of patients. Mean DLQI scores were high among the age group of 41-70 years, male sex and in patients who had <1 month duration of the dermatoses. Regarding individual dermatoses, infestation (scabies) was having higher mean DLQI scores and it was statistically significant. This study depicts that NVD are having impact on the QOL and its mainly attributed to the site of dermatoses and also due to the symptoms. Proper counseling about the nature of these disorders and prompt treatment were important, thereby improving the QOL of such patients.

Clinical and Demographic Patterns of Vulval Dermatoses and Their Impact on Quality of Life.

Vulval dermatoses may present with varied manifestations ranging from asymptomatic to chronic disabling conditions. The multifactorial nature of symptoms and physical expression of the disease on the vulva complicate the evaluation and management of genital dermatoses, thereby severely impairing the quality of life of patients. To study the clinical patterns and socio-demographic features of vulval dermatoses and their impact on the quality of life using the dermatology life quality index (DLQI) questionnaire. Female patients of all age groups who attended our outpatient department (OPD) from October 2019 to March 2021 with vulval lesions were included in the study after a detailed history and complete examination. Based on sites of involvement, the lesions were classified as genital lesions alone, genital and skin lesions, oro-genital lesions, and oro-genital and skin lesions. DLQI score was assessed using the DLQI questionnaire. In total, 520 patients were recruited for the study after following the inclusion and exclusion criteria. The most common age group was 31-40 years (33.65%). The majority of the patients were married (91.92%), housewives (82.88%), and illiterate (49.61%) women. The most common presenting symptom was itching (43%). The most common vulval dermatoses were infections, seen in 401 (77.11%) patients, followed by inflammatory diseases in 78 (15%) patients, and immunobullous diseases (1.53%). Patients with genital, skin, and oral involvement showed statistically significant higher DLQI scores (P value < 0.05). Patients with immunobullous disorders had the highest mean DLQI scores. As this study was a hospital-based study, the observations may not represent and reflect the general population. Patients with genital, skin, and oral lesions had the highest DLQI scores, indicating higher impact on the quality of life. Assessment of the disease's impact on the quality of life is essential because it not only aids in early management but also helps in minimizing the duration of the ailment.

Descriptive study of sweat dermatitis: A rare dermatoses not so rare in tropics

BackgroundSweat dermatitis is an irritant inflammatory dermatosis commonly encountered in tropics during summers. Profuse sweating triggered by high heat index, friction, clothing, outdoor activities, military training, overcrowding, prolonged working in ill-ventilated places, etc., are responsible or this dermatitis. Aim was to study the clinical, dermoscopic, vapometric, histopathological, and immunohistochemistry (IHC) findings in sweat dermatitis. MethodsTwenty-five patients of sweat dermatitis attending out-patient department (OPD) of tertiary care hospital, were recruited over a period of three months (June to August 2022). A detailed history was followed by dermatological examination, dermoscopy, vapometry, histopathology, and IHC studies. ResultsTwenty-five patients were included in the study. There was male preponderance with male: female ratio of 2.1:1. The mean age of patients was 30.36 years. Dermatological examination in all patients revealed brownish “parchment”-like, shiny “crinkled cellophane paper”-like patches over the entire upper back and shoulder region with areas of exfoliation. Dermoscopy revealed increased skin markings, deep brown pigmentary changes with superimposed whitish scales with islands of eroded skin, and prominent eccrine duct openings. Vapometric analysis revealed increased transepidermal water loss (TEWL) in the affected area in 88% of patients. Histopathological examination showed features of spongiotic dermatitis. IHC with CK7 (cytoplasmic) highlighted the normal eccrine coils. ConclusionSweat dermatitis is common seasonal dermatoses in tropics, but it remains undiagnosed due to lack of awareness. This study aims to sensitize medical doctors and dermatologists about sweat dermatitis and prevention strategies that can be helpful in mitigating it. The study also discusses the role of investigative modalities, such as dermoscopy, vapometry, histopathology, and IHC, in sweat dermatitis.

Dermoscopy in pediatric dermatosis

Pediatric dermatoses differ from adult dermatoses with respect to clinical presentation, treatment, and prognosis. These can be transitory, chronic, and recurrent. Diagnosing these conditions is at times a challenge, and the use of dermoscope aids it. Dermoscopy in pediatric population has a unique advantage as it poses neither physical discomfort nor emotional stress. Therefore, this review was attempted to highlight the salient dermoscopy features of common dermatoses in pediatric age group. A systematic literature search using PubMed and Google Scholar databases for English language articles published up to the end of May 2019 was done for pediatric dermatoses and dermoscopy. Relevant studies were included. Cross-references from each study are also included. The common dermoscopy features of “atopic dermatitis,” “lichen planus,” “psoriasis,” “paediatric dermatoses,” “keratosis pilaris,” “impetigo,” “pityriasis rosea,” “pityriasis versicolor,” “granuloma annulare,” “vitiligo,” “hypomelanoses of Ito,” “nevus achromicus,” “molluscum contagiosum,” “verrucae,” “lentigines,” “freckles,” “capitis,” “pediculosis,” “alopecia areata,” “linear porokeratosis,” “lichen sclerosus et atrophicus (LS et A),” “pityriasis alba,” “acanthosis nigricans,” “hand foot mouth,” “seborrheic dermatitis,” and “prurigo nodularis” identified from literature search were included. Pediatric dermatoses are unique in presentation as they might overlap to some extent. The diagnosis of these conditions is complicated by the fact that a biopsy may not always be possible since children are not co-operative, and more importantly, parents are reluctant to subject their children to an invasive procedure. It is in this perspective that dermoscopy assumes greater importance in pediatric dermatology as compared to that in adults.

Non- venereal genital dermatoses in adult female: A hospital based observational study

Background: Any genital dermatoses in a sexually active female are first considered to be venereal dermatoses. Venereal diseases are the primary concern of the affected patient and are associated with mental distress and guilt. Because of the associated embarrassment and psychological sequelae, women do not seek medical care; thus, it is crucial to have proper knowledge of various non-venereal dermatoses and their varied presentations. Method: It was a observational study which included a total of 170 patients attended Dermatology department over a period of 18 months from January 2020 to June 2021. Cases having any venereal diseases were excluded from the study. Scabies and dermatophytic infections were excluded. Result: The incidence of non-venreal dermatoses among female patients attending OPD is not common. Most common age group affected was between 18 to 30 years which is reproductive age group. These are broadly divided into different categories like Inflammatory, Autoimmune, Multisystem diseases, Exogenous, Benign and malignant neoplasms. Most common dermatoses observed were Candidosis (32 cases) and Pemphigus vulgaris (12 cases). Conclusion: Non venereal genital dermatoses are more prevalent among reproductively active females and has more or less uniform clinical pattern across the country. Maximum number of dermatoses in females are benign and require no aggressive therapeutic approach. This study was helpful in knowing the clinical pattern and management of different non-venereal genital dermatoses and distinguishing them from venereal dermatoses which helps in reducing guilt among the patients.

Non venereal Female Genital Dermatoses: Beyond Sexually Transmitted Infections: A Cross-sectional Study

Introduction: Genital dermatoses can be categorised as either venereal or non venereal. Non venereal genital dermatoses have various causes, and their presentation may differ from that of cutaneous lesions due to local factors. Therefore, it is crucial to have a proper understanding in order to differentiate non sexually transmitted genital dermatoses from sexually transmitted ones. Aim: To study the clinical patterns of non sexually transmitted genital dermatoses in females aged above 18 years. Materials and Methods: A cross-sectional study was conducted at the Outpatient Department (OPD) of Dermatology at a Tertiary Care Hospital in Chennai, India, over a period of one year and six months. It involved 120 female patients above 18 years of age who were diagnosed with non venereal genital dermatosis. All patients were included in the study after providing informed consent. Patients with a history of significant anatomical alterations due to trauma or surgery were excluded. A detailed clinical history was obtained, followed by a thorough dermatological examination. After diagnosing non venereal genital dermatoses, classification based on aetiology and site of involvement was performed. The presence, distribution, and any associated conditions were also studied. Data was entered into a Microsoft Excel datasheet and analysed using Statistical Package for Social Sciences (SPSS) version 22.0. Categorical data was presented as frequencies and proportions. Results: The mean age of the study participants was 43.08 years. The present study identified 21 different types of non venereal dermatoses, with infectious dermatosis being the most common in 60 (50%) cases, followed by inflammatory dermatosis 33 (27.5%) cases, miscellaneous conditions in 19 (15.83%) cases, benign and physiological conditions in 7 (5.83%) cases, and malignancies in 1 (0.83%) case.. Vulvovaginal candidiasis was the most common dermatosis observed in the present study, accounting for 21 cases (17.5%) of the entire study population. Conclusion: Genital diseases can cause significant psychological trauma and anxiety for patients. It is important to note that not all genital dermatoses are sexually transmitted. Non-venereal dermatoses affecting the external genitalia in females encompass a spectrum of diseases with diverse aetiologies. Therefore, accurate diagnosis of these non venereal dermatoses is crucial to alleviate the patient’s concerns regarding sexually transmitted diseases and the associated stigma.

Tinea capitis: new insights into an old disease

Tinea capitis is a superficial dermatophytic infection of the scalp. This common dermatosis occurs predominantly in children. The clinical manifestation of the disease is heterogeneous, and vary widely depending on the pathogenic fungal agent. Direct mycological examination and cultures are mandatory for an accurate diagnosis and species identification. Treatment should be both local and systemic, and ideally is tailored to the dermatophytic species identified by the laboratory diagnostic work up. Secondary prophylaxis through supplementary measures is crucial to avoid epidemic outbreak and patient reinfection.

Clinicodemographic Characteristics of Cutaneous Larva Migrans: A 10-year Study In Tertiary Referral Hospital-West Java, Indonesia

Background: Cutaneous larva migrans (CLM) is the most common helminthic dermatosis caused by animal hookworm, commonly reported in tropical and subtropical regions. Most studies are on travellers returning from endemic areas, paradoxically very few reports in endemic countries, including Indonesia, where they mostly take place. This study aimed to describe the demographic and clinical characteristics of CLM patients for 10 years in a tertiary referral hospital in West Java, Indonesia.

Clinicodemographic Characteristics of Cutaneous Larva Migrans: A 10-year Study In Tertiary Referral Hospital-West Java, Indonesia

Background: Cutaneous larva migrans (CLM) is the most common helminthic dermatosis caused by animal hookworm, commonly reported in tropical and subtropical regions. Most studies are on travellers returning from endemic areas, paradoxically very few reports in endemic countries, including Indonesia, where they mostly take place. This study aimed to describe the demographic and clinical characteristics of CLM patients for 10 years in a tertiary referral hospital in West Java, Indonesia.

Menopause, skin and common dermatoses. Part 2: skin disorders.

In this second part of a four-part review, we examine the effect of menopause on the skin. Menopause and the associated hypo-oestrogenic state have implications for the structure and function of the skin. We performed a literature review to investigate the impact of the menopause on common dermatoses. There is evidence that oestrogen is implicated in transepidermal water loss and reduction in dermal collagen. There are associations with menopause and multiple common dermatoses, including xerosis and pruritus, hidradenitis suppurativa and psoriasis. Menopause has a clear impact on the skin and common dermatological conditions. Further research to understand the mechanisms and explore therapeutic options is needed.

Menopause, skin and common dermatoses. Part 1: hair disorders.

Menopause, which usually occurs between the age of 45 and 55 years, is associated with falling oestrogen levels due to ovarian follicle depletion. The impact on the cardiovascular system and bone density are well documented; however, further research required to establish the impact on the skin and hair. In this first part of a four-part review, we examine the effect of menopause on the hair. We performed a literature review on dermatology and hair in menopause. Androgens and oestrogens are involved with regulation of the hair cycle, with a reduction in anagen hairs seen in postmenopausal women. Female pattern hair loss and frontal fibrosing alopecia have both been associated with the perimenopausal and postmenopausal states. It is clear that menopause and the change in hormone levels have an impact on the hair cycle and common hair conditions. However, further research is required, particularly to understand the therapeutic targets and role of hormonal therapy.

Menopause, skin and common dermatosis. Part 3: genital disorders.

Oestrogen plays a vital role in maintaining a normal vulvovaginal epithelium, vaginal lubrication, as well as a healthy microbiome to ensure an acidic pH. The decrease in oestrogen levels in women going through menopause results in both physiological and physical changes of the genitourinary system, and more specifically the vulva. We conducted a literature review on the effects of low oestrogen levels on the physiology and function of the vulva and the vulvovaginal epithelium. 'Genitourinary syndrome of menopause' (GSM) is the term used to describe the signs and symptoms of a low oestrogen state. The symptoms and signs of GSM can overlap or coexist with other vulval dermatoses. Expert opinion is needed to diagnose and manage vulval dermatoses in menopause. This article will discuss the signs and symptoms of GSM, as well as the different management options available. Other vulval dermatoses that can be affected by hypo-oestrogenism are also reviewed.

Menopause, skin and common dermatoses. Part 4: oral disorders.

The physiological impact of declining oestrogen levels during menopause has been well documented. We conducted a literature review to assess the impact of menopause on oral health. Falling oestrogen levels are associated with adverse effects on the gingival, oral and buccal epithelia. The symptoms prevalent in perimenopausal and postmenopausal women range from dry mouth to immune-mediated mucocutaneous disease and burning mouth syndrome. Our review has highlighted the need for further research into potential treatments for oral symptoms in menopause, particularly with regard to hormone replacement therapy.

A clinical-epidemiological study of facial dermatoses in women

The face is the most prominent part of the body. Facial blemishes and disorders directly reflect a person's physical appearance, cosmesis and self-image. They may contribute to dysmorphism and even lead to depression in susceptible individuals, especially women. Early identification and management of facial skin disorders are therefore important.&#x0D; The aim: To study the clinical pattern and epidemiological determinants of facial dermatoses among females above 10 years.&#x0D; Methods: This cross-sectional study was conducted among female patients with facial dermatoses, with informed consent, at a rural tertiary hospital for 18 months.&#x0D; Results: A total of 500 patients were enrolled. The majority were in the 4th and 5th decades. Pigmentary dermatoses were highest, melasma predominating. Immunobullous dermatoses formed the smallest group. Occupation-wise, the majority were agricultural labourers. Many dermatoses, especially melasma, were related to occupation and lifestyle with photo-aggravation, cosmetics use and stress.&#x0D; Conclusion: This study assessed the pattern of facial dermatoses among the female clientele of this institution. Hyperpigmentary dermatoses, especially melasma, emerged as the most common dermatosis for which treatment was sought