Dermatological Diseases Research Articles

Herbal Medicine in Children and Adults With Atopic Dermatitis: A Systematic Review and Meta-Analysis.

Herbal medicine is widely used for dermatological diseases, particularly atopic dermatitis. This study aims to systematically review existing literature on the efficacy of both topical and systemic herbal interventions for atopic dermatitis across various age groups. Conducting a comprehensive search on MEDLINE/PubMed, Scopus, and the Cochrane Central Register of Controlled Trials (Central) until April 12, 2023, only randomized controlled trials (RCTs) were included. The review is reported following the PRISMA guidelines and was conducted in accordance to Cochrane recommendations. Two authors independently extracted details, including demographics, medication, control/placebo groups, outcomes, adverse events, and results, with quality assessment using the Cochrane risk of bias tool 2.0. A meta-analysis, utilizing the random-effects model, was conducted, and publication bias was assessed through funnel plot inspection. The quality of evidence adhered to GRADE working group recommendations. The primary focus was evaluating atopic dermatitis or pruritus severity. The review encompassed 51 RCTs (3763 participants). Of these, 31 RCTs explored 19 distinct herbs and five complex remedies, whereas 20 RCTs (1088 participants) specifically investigated evening primrose oil (EPO). Herbs such as sunflower, licorice, figs, coconut, EPO, indigo naturalis, licorice, mauve, St. John's wort, and a combination of aloe vera and olive oil were found to have evidence of efficacy in the local treatment of atopic dermatitis. A meta-analysis on systemic used EPO, involving 13 RCTs, found no significant difference in atopic dermatitis severity compared with placebo (SMD: 0.14; 95% CI [-0.45; 0.73], 13 RCTs). In conclusion, this review provides a nuanced perspective on herbal substance efficacy for atopic dermatitis. While the EPO meta-analysis failed to show a discernible benefit beyond placebo, individual herbal preparations showed promising results in RCTs included in this review. Nevertheless, larger, methodologically rigorous studies are essential to establish evidence for herbal remedies in atopic dermatitis treatment.

Prevalence of Osteoporosis in Patients with Chronic Skin Diseases

Abstract Osteoporosis is a skeletal disorder resulting from decreased bone mass that results in increased liability to fractures. Several chronic diseases including dermatological diseases were reported to affect bone mineral density with resulting osteopenia and osteoporosis. Aim of the Study to evaluate the prevalence of osteopenia and osteoporosis in chronic skin diseases. Patients and Methods One hundred patients diagnosed with chronic primary dermatological diseases divided into 4 groups according to dermatological disease were included in the current study. Assessment of BMD by DEXA scan and estimation of serum level of vitamin D were performed. Results In all studied patients, there was no significant association between osteopenia/osteoporosis and studied dermatological diseases or vitamin D levels as T score analysis either lumbar, femoral or forearm in relation to vitamin D status and disease severity. There was significant association of insufficient vitamin D levels with all skin diseases but there was no significant association between T score results and vitamin D status in studied patients. Conclusion The current study revealed that dermatological diseases were associated with insufficient levels of vitamin D.

Helicobacter Pylori: Beyond The Gut - Insights Into Its Association With Dermatological Conditions

Introduction: Helicobacter pylori (H. pylori) is a Gram-negative bacterium associated with gastrointestinal diseases and extra-gastrointestinal manifestations, including dermatological conditions. Understanding the precise mechanisms and clinical implications of the H. pylori skin disorder association is essential. Materials and methods: A cross-sectional observational study was conducted at a private dermatology center in Ahmedabad, Gujarat, from January 2021 to August 2023. Patients coming with various dermatological conditions and with suspected H. pylori infection underwent clinical examination, laboratory tests, and skin biopsy to confirm the diagnosis of disease. The statistical analysis assessed associations between demographics, dermatological conditions, and H. pylori antibody test results. Laboratory Investigation: H. pylori antibody levels were measured using serology by doing H.pylori IgG antibody level testing and cut-off values of >0.90 were considered positive. Statistical Analysis: Data entry and analysis involved Microsoft Excel 360, calculating proportions, and percentages, and drawing appropriate inferences. Results: Of 1131 enrolled patients (male-female ratio 1:1.43), 22% tested positive for H. pylori, with higher positivity rates in patients aged >60 years and 40-60 years. Analysis revealed varying proportions of H. pylori positivity across dermatological conditions, with alopecia areata and chronic urticaria showing the highest rates. Conclusions: While studies suggest H. pylori’s involvement in dermatological diseases, further research is needed to understand this relationship fully. Systematic investigations into the impact of eradication therapy are essential to inform clinical management strategies and guide future research directions.

Thiostrepton induces oxidative stress, mitochondrial dysfunction and ferroptosis in HaCaT cells

TST has been mainly studied for its anti-tumor proliferation and antimicrobial effects, but not widely used in dermatological diseases. The mechanism of cellular damage by TST in response to H2O2-mediated oxidative stress was investigated in human skin immortalized keratinocytes (HaCaT) as an in vitro model. The findings reveal that TST treatment leads to increased oxidative stress in the cells by reducing levels of superoxide dismutase (SOD), glutathione (GSH), and catalase (CAT). This effect is further supported by an upsurge in the expression of malondialdehyde (MDA, a pivotal marker of lipid peroxidation). Additionally, dysregulation of FoxM1 at both gene and protein levels corroborates its involvement TST associated effects. Analysis of ferroptosis-related genes confirms dysregulation following TST treatment in HaCaT cells. Furthermore, TST treatment exhibits effects on mitochondrial morphology and function, affirming its induction of apoptosis in the cells through heightened oxidative stress due to mitochondrial damage and dysregulation of mitochondrial membrane potential.

Ethnobotanical study of medicinal plants in Sekela District, northwestern Ethiopia

BackgroundPeople in Sekela District, like others in Ethiopia, have a long tradition of using medicinal plants to treat human and livestock ailments. However, medicinal plants and their associated indigenous knowledge are currently under threat. Thus, the study was carried out to compile ethnobotanical knowledge about medicinal plants in the district. MethodsA total of 352 informants from six study sub-districts (328 general and 24 key informants) were selected randomly and purposefully. Individual interviews, focus group discussions, guided field walks, and market surveys were used to acquire ethnobotanical data using semi structured interview questions. The informant consensus factor (ICF), fidelity level, preference ranking, direct matrix ranking, medicinal use, and Analysis of Variance were used. ResultsA total of 121 medicinal plants belonging to 106 genera and 55 families were documented. The Asteraceae family had the most species with 11 (9 %), followed by Lamiaceae with 8 (6.6 %), while leaves were the most utilized part with 56 (37 %). The majority of the remedies were made as a concoction (32, 17 %) and delivered orally (98, 57 %). There was a statistically significant difference in indigenous knowledge on medicinal plants among genders, ages, marital status, educational levels, and occupations (p ˂ 0.05). The dermatological disease categories had the highest ICF (0.92) in human ailments. ConclusionThe study revealed that Sekela District is rich in medicinal plants for treating human and livestock ailments, and has indigenous knowledge to utilize these resources effectively. However, overgrazing, agricultural expansion, and improper harvesting techniques threaten medicinal plants. This signals the need to make significant efforts to raise public awareness about their conservation and sustainable use.

Evaluation of Oxidative Stress in Cutaneous Leishmaniasis in Iraqi Patients

Abstract Background: This study evaluated the oxidative—antioxidative status of patients with cutaneous leishmaniasis (CL) and to establish the data alteration among the patients and the control. Objectives: To determine serum levels of malondialdehyde (MDA), serum uric acid (UA), and catalase enzyme as a markers of oxidative stress in the patients suffering from CL. Materials and Methods: A total of 46 patients with CL (22 males and 24 females) aged between 5 and 60 years were subjected to investigations. Out of the total sample, 42 healthy persons (28 males and 14 females) functioned as control group, patients who received anti-leishmaniasis treatment locally or systemically for their cutaneous lesions and also patients with chronic history of medical disease or drug history for systemic or dermatological diseases were not included in this study. Results: For comparative evaluation of oxidative stress markers between patients and control; there were a significant increase in lipid peroxidation marker; serum MDA and non-enzymatic antioxidant marker—serum UA in the patient group in comparison to the control group, with non-significant decrease in enzymatic antioxidant—serum catalase enzyme in patients as compared with control groups. There is negative significant relationship for decrease of catalase enzyme for patients with CL above age of 15 years. The study of the patients with CL that is, associated with secondary bacterial infection shows a significant decrease in serum catalase enzyme when compared with control group. Conclusions: 1. The results of this study clearly demonstrate the importance of serum MDA as an early biochemical indicator of peroxidative damage resulting from CL. 2. Increased serum UA, and decrease in serum catalase enzyme provided a free radical scavenger’s action.

Drug Delivery Systems based on Microneedles for Dermatological Diseases and Aesthetic Enhancement.

Microneedle (MN) devices comprise of micron-sized structures that circumvent biological barriers in a minimally invasive manner. MN research continues to grow and evolve; the technology was recently identified as one of the top ten overall emerging technologies of 2020. There is a growing interest in using such devices in cosmetology and dermatological conditions where the MNs mechanically disrupt the outer skin barrier layer, creating transient pathways that allow the passage of materials to underlying skin layers. This review aims to appraise the application of microneedle technologies in skin science, provide information on potential clinical benefits, as well as indicate possible dermatological conditions that can benefit from this technology, including autoimmunemediated inflammatory skin diseases, skin aging, hyperpigmentation, and skin tumors. A literature review was carried out to select studies that evaluated the use of microneedles to enhance drug delivery for dermatologic purposes. MN patches create temporary pathways that allow the passage of therapeutic material to deeper layers of the skin. Given their demonstrable promise in therapeutic applications it will be essential for healthcare professionals to engage with these new delivery systems as they transition to the clinic.

Effect of Body Image and Social Comparison towards Life Satisfaction in Adolescents with Acne Vulgaris

Life satisfaction levels are known to be lower in people with acne vulgaris than in those who do not have this dermatological disease. This research looked at whether there was an effect between body image and social comparison on life satisfaction in adolescents with acne vulgaris. This study uses a correlational quantitative method with Satisfcation with Life Scale (SWLS), Multidimensional Body Self Relations Questionnaire – Appearrance Scales (MBSRQ-AS), and Iowa-Netherlands Comparison Orientation Scale as research instruments. The subjects of this study are adolescents with acne vulgaris as many as 352 people. Sampling was carried out by purposive sampling. This study uses multiple linear regression analysis. The results of the analysis revealed that body image affects life satisfaction and social comparison also affects life satisfaction. The two independent variables were also proven to jointly affect life satisfaction with a percentage of 39.2%.

Physiological justification of diagnostic and therapeutic measures for allergic flea dermatitis

In modern conditions, the percentage of allergic diseases increases every year. A sufficient number of studies have been devoted to the study of various aspects of the pathology under consideration in small pets, but its solution will contribute to a comfortable life for the patient. According to the conducted research, it was found that among dermatological diseases, there were such as allergic: in cats 22.2%, in dogs 15.5%; parasitic in cats 13.3%, in dogs 10.5%; fungal in cats 6.3%, in dogs 7.2%, bacterial in cats 5.8%, in dogs 6.4%; thermal in cats 5.2%, in dogs 2.3%, chemical in cats 5.3%, in dogs 2.2%. Flea allergic dermatitis is a hypersensitivity reaction to one or more components of fleas, especially to allergens contained in their saliva. Flea dermatitis is most often recorded in late summer, which corresponds to the peak of flea numbers. The purpose of flea control is to eliminate them on pets, eliminate existing contamination in the environment and prevent re-infection. The main symptoms indicating allergic flea dermatitis: severe itching; numerous wounds due to scratching; hair falling out, the appearance of bald patches on the animal's body, ulcers covered with crusts; lack of appetite, vomiting; inappropriate behavior, irritability. When diagnosing allergic flea dermatitis, a number of factors were taken into account, including anamnesis, clinical signs, results of a wet test for the presence of fleas or their excrement, cytology of skin scraping, as well as the exclusion of other causes of dermatological diseases including atopic dermatitis and food allergies. The clinical signs of allergic flea dermatitis are variable and depend on the duration of the disease, as well as the degree of hypersensitivity and the consequences of previous or current treatment.

More than just dermatitis: The multifaceted nature of chronic itch through the historical perspective of Napoleon Bonaparte

Derived from the survival advantage needed to eradicate harmful irritants from the skin's surface, itch, also known as pruritus, is an intriguing phenomenon and a key feature of many dermatologic diseases. The pathologic form, chronic itch, is a condition that precedes itself by its complex pathophysiology, numerous etiologies, and interplay of mechanisms that often make it difficult to diagnose and treat. One particular sufferer of this condition, the 18th-century French emperor Napoleon Bonaparte, makes for a compelling case study of the complexity of chronic itch. We delve into the many etiologies and mechanisms of chronic itch, using Napoleon's lifelong struggle with this condition as our model, identifying potential environmental, neurologic, psychiatric, and immunologic origins of his condition.

Measurement properties and interpretability of the Patient-Reported Impact of Dermatological Diseases (PRIDD) measure.

Patient-reported outcome measures (PROMs) are crucial for assessing the impact of dermatological conditions on patients' lives, but the existing dermatology-specific PROMs are not recommended for use according to the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN). We developed the Patient-Reported Impact of Dermatological Diseases (PRIDD) measure in partnership with patients. It has strong evidence of content validity, structural validity, internal consistency, acceptability, and feasibility. To test PRIDD's remaining measurement properties and establish the interpretability of scores against the COSMIN criteria using classic and modern psychometric methods. A global longitudinal study consisting of two online surveys administered two to four weeks apart. Adults (≥ 18 years) living with a dermatological condition were recruited through the International Alliance of Dermatology Patient Organizations' (GlobalSkin) membership network. Participants completed PRIDD, a demographics questionnaire, and other related measures including the Dermatology Life Quality Index (DLQI). We tested PRIDD's criterion validity, construct validity and responsiveness (Spearman's ρ, independent-samples t-tests and ANOVA), test-retest reliability (interclass correlation coefficient [ICC]), measurement error (Smallest Detectable Change or Limits of Agreement [LoA], distribution-based Minimally Important Change [MIC]), floor and ceiling effects (number of minimum and maximum scores and Person-Item Location Distribution Maps), score bandings (κ coefficient of agreement) and anchor-based MIC. 504 patients with 35 dermatological conditions from 38 countries participated. Criterion validity (ρ = 0.79), construct validity (76% hypotheses met), test-retest validity (ICC = 0.93), and measurement error (LoA = 1.3 < MIC = 4.14) were sufficient. Floor and ceiling effects were in the acceptable range (< 15%). Score bandings were determined (κ = 0.47), however, the anchor-based MIC could not be calculated due to an insufficient anchor. PRIDD is a valid and reliable tool to evaluate the impact of dermatological disease on patients' lives in research and clinical practice. It is the first dermatology-specific PROM to meet the COSMIN criteria. These results support the value of developing and validating PROMs with a patient-centred approach and using classic and modern psychometric methods. Further testing of responsiveness and MIC, cross-cultural translation, linguistic validation, and global data collection are planned.

Risk Factors Associated with Cutaneous Reactions Following COVID-19 Vaccine Immunisation: A Registry-Based Case-Control Study.

In Malaysia, following extensive COVID-19 vaccination, Hospital Kuala Lumpur reported an increase in cutaneous reactions post-immunisation. To understand this, a case-control study was initiated to identify potential risk factors. This registry-based, unmatched case-control study encompasses all adverse event following immunisation (AEFI) reports associated with COVID-19 vaccines, received by the Department of Pharmacy at Hospital Kuala Lumpur through the Malaysian Adverse Drug Reactions Advisory Committee (MADRAC) AEFI reporting forms. Twenty-four potential risk factors were evaluated, including demographic information, medical history, food allergies, COVID-19 vaccination history and prior SARS-CoV-2 infection, were evaluated using MADRAC AEFI reporting forms. Odds ratio (OR) with 95% confidence interval (CI) were estimated using univariable and multivariable logistic regression. Cutaneous reactions were more frequent in middle-aged females, especially after the first COVID-19 vaccine dose. These reactions, primarily mild and generalised, included pruritus and urticaria. Notably, 52% were delayed reactions (more than 4 h post-vaccination). Factors associated with increased risk of cutaneous reaction following COVID-19 immunisation included history of seafood and shellfish allergy (adjusted odds ratio [adjOR]: 2.11; 95% CI: 1.12, 3.96; P = 0.020), history of vaccine allergy (adjOR: 4.07; 95% CI: 1.44, 11.54; P = 0.008), past dermatological diseases (adjOR: 5.48; 95% CI: 2.03, 14.78; P = 0.001), and past medication allergy (adjOR: 2.12; 95% CI: 1.36, 3.31; P = 0.001). Self-reported histories of allergies to vaccines, foods or medications were found to increase the likelihood of cutaneous reactions following COVID-19 vaccination. These reactions, which were predominantly mild, did not hinder the administration of the second vaccine dose. The majority of reactions occurred after the first dose, manifesting as generalised pruritus and urticaria. They were effectively managed with oral antihistamines and low-dose corticosteroids, thereby avoiding the need for hospitalisation.

Matrine-loaded self-adhesive swelling microneedle for inflammation regulation to improve eczema treatment

Eczema is a common chronic dermatological disease. Conventional treatments exhibit limited efficacy due to fast drug release resulting in short-term relief. Development of a new treatment strategy that enables sustained drug release and long-term maintenance on the skin surface is necessary. A self-adhesive swelling microneedle patch (SDSMNs) was designed and constructed using a two-step casting method. The adhesive substrate was prepared by blending gelatin and dopamine via oxidation of NaIO4, so it could adhere onto the skin surface as well as withstand repeated bending movement without detachment. The swelling needles were fabricated using polyvinyl alcohol (PVA) and polyvinylpyrrolidone (PVP), which could swell by absorbing interstitial fluid and release the drug in a controlled manner. SDSMNs also showed desirable antibacterial activities toward E. coli and S. aureus. The adhesive microneedles loaded with matrine (MAT-SDSMNs), an anti-inflammatory Chinese medicine, dramatically relieved eczema symptoms through IL-17 mediated inflammation responses. The use of MAT-SDSMNs significantly decreased the infiltration of inflammation cells and level of inflammatory cytokines, reduced the skin thickness, and increased collagen deposition fraction compared with conventional ointment or subcutaneous injection. The results suggested that MAT-SDSMNs can improve eczema treatment by regulating the local inflammatory microenvironment, providing a simple, self-administered sustainable strategy for eczema treatment.

Dermatologic adverse events caused by biologic treatments - Pathogenesis and management.

Biologics are approved for various dermatologic, allergic, rheumatic, and gastroenterologic inflammatory diseases, as well as for numerous malignancies. The dermatologic adverse events from treatment with biologics may resemble primary inflammatory diseases but differ in pathogenesis. In this article, we describe five different pathogenic mechanisms of dermatologic adverse events. By studying these mechanisms, we hope to gain valuable insights into the pathogenesis of primary inflammatory diseases. In addition, in this article, we provide recommendations for the treatment and management of the dermatological adverse events induced by biologics.

Many faces of cutaneous leishmaniasis.

Our objective in this study is to determine the atypical clinical presentations of cutaneous leishmaniasis (CL) patients diagnosed in Şanlıurfa province. This retrospective study included 213 patients with atypical clinical presentations among 1751 patients diagnosed with CL between October 2019 and August 2022 in Şanlıurfa Oriental Boil Diagnosis and Treatment Center located in an endemic region for CL. We found the prevalence of atypical CL to be 12.1%. The most common atypical lesions were lupoid 21 (9.8%), erysipeloid 16 (7.5%), impetiginous 16 (7.5%), recidivan 15 (7%), eczematous 15 (7%), ecthyma-like 13 (6.1%), pyoderma gangrenous-like 12 (5.6%), and sporotrichoid 12 (5.6%). Other lesions with atypical clinical presentations: chalazion-like, verrucous, dental sinus-like, psoriasiform, zosteriform, lymphoma-like, juvenile xanthogranuloma-like, volcano-like, paronychial, basal cell carcinoma-like, squamous cell carcinoma-like, herpes labialis-like, keratoacanthoma-like, chancriform, annular, lichenoid, mastocitoma-like, keloidal, epidermoid cyst-like, kaposi sarcoma-like, scar leishmaniasis, granulomatous cheilitis-like, mycetoma-like, molluscum contagiosum-like, discoid lupus erythematosus-like, and dermatofibroma-like. In addition to the atypical clinical presentations previously reported, we also defined dermatofibroma-like, Kaposi sarcoma-like, dental sinus-like, juvenile xanthogranuloma-like, mastocytoma-like, and epidermoid cyst-like. It should be kept in mind that CL can clinically mimic many infectious, inflammatory, and neoplastic diseases, which should be considered in the differential diagnosis of long-term non-healing lesions, especially in endemic areas. Key message What is already known on this subject: CL is known as the great imitator disease in dermatology. What this study adds: In addition to the atypical clinical presentations previously reported, we also defined dermatofibroma-like, Kaposi sarcoma-like, dental sinus-like, juvenile xanthogranuloma-like, mastocytoma-like, and epidermoid cyst-like. How this study might affect research, practice, or policy: CL can clinically mimic many infectious, inflammatory and neoplastic diseases, which should be considered in the differential diagnosis of long-term non-healing lesions, especially in endemic areas.

Composition and diversity of 16S rRNA based skin bacterial microbiome in healthy horses

Characterization of microbiota structure on the skin of healthy horses is important for further development of modulation strategies to ensure optimal bacterial composition for physiological processes. This requirement is also supported by the relatively high incidence of dermatological diseases in horses and thus the need to manage them therapeutically. The taxonomic analysis of skin samples (n = 30) from five different body parts of clinically healthy Shetlands ponies females (neck, back, abdomen, pastern, muzzle) kept under homogeneous conditions (in open stalls with paddock, feed with dry hay, green grass ad libitum and granulated feed) was performed using amplification of V3—V4 region of the 16S rRNA gene. Results indicate that bacteria associated with healthy equine skin represent 18 phyla, 29 classes and 119 families. The most abundant phyla were Proteobacteria (30.8 ± 9.1%) followed by Actinobacteriota (20.4 ± 7.6%), Firmicutes (19.5 ± 10.1%), Bacteroidota (8.5 ± 5.0%) and Deinococcota (7.2 ± 14.8%). Among 229 genera identified, Corynebacterium (7.4 ± 6.5%) was the most abundant genus in skin sites of horses, followed by Deinococcus (7.1 ± 14.9%) and Macrococcus (5.0 ± 8.2%). Indices for the richness and diversity of species within bacterial populations for five regions of horses skin revealed no significant variations observed for species richness (Chao1, p-value 0.2001) but significant result for species evenness (Shannon, p-value 0.0049) with maximum on the neck and minimum on the back skin site. The clustering was seen across samples from different skin sites but also across samples collected from individual horses.

Effects of cutaneous leishmaniasis on patients’ quality of life

IntroductionCutaneous Leishmaniasis (CL) is caused by protozoan parasite called Leishmania. It is endemic in more than 100 countries globally. Despite its vast prevalence and impact on quality of life, it is one of the most neglected tropical dermatological diseases. The CL burden has often been expressed based on the physical disfigurement caused by the disease. However, considering the impact of the disease beyond physical impairment and changes in patients’ appearance would help to better understand the disease as a public health problem. The effect of CL on patients’ quality of life was determined in this study.MethodsThe data that were related to quality of life were collected using Standard one-week Dermatology Life Quality Index (DLQI) questionnaire. The questions were categorized under seven domains: symptoms & feelings, daily activities, work and school, leisure, personal relationships, and treatment. Each question was scored on a three-point scale: Very much (3), A lot (2), A little (1), Undecided (0), and Not at all (0). The sum of the scores lied between 0 and 48. A higher score shows worse quality of life. The data were entered and analysed using Statistical Package for Social Science 23. Frequencies and proportions were used to describe the data. Differences were considered statistically significant at p < 0.05.ResultsThe lives of the majority of CL patients (60.7%) were significantly affected by CL. The quality of life of patients was moderately impacted by CL in 25% of the CL patients. In 32.1% of the CL patients, the effect of CL on patients’ quality of life was very large. The quality of one CL patient’s life was extremely largely affected. The disease had a small effect on 32.1% of the CL patients. Personal relationship was the most affected domain followed by symptoms and feelings and treatment. Future study including rural regions is required.ConclusionThe Dermatology Life Quality Index demonstrates that CL has a small to extremely very large negative effect on the quality of life of patients.

(136) LABIA MINORA: A COMPREHENSIVE REVIEW

Abstract Introduction The labia minora (LM) is a part of the external female genitalia that varies greatly in form and appearance, and changes at each developmental stage of a woman. Its highly neurovascular nature and proximity to the clitoris allows it to play a vital role in sexual function. Along with the labia majora, it helps to protect the opening of the urethra and vagina. The perception of a normal LM is dependent on cultural and social context and influences the kinds of procedures that are done on the LM. Objective This study aims to comprehensively review labial anatomy, development, pathology, its role in sexual function, perceptions of labial appearance, and labial procedures. The goal is to understand the mechanism and purpose of the evolution of the LM and its effects on anatomical and sexual function. Methods We reviewed journal articles from 1988 to 2023 concerning labial anatomy, physiology, pathology, piercings, tattoos, and labial procedures such as labiaplasty, genital mutilation, episiotomies. We also reviewed cultural perceptions of its structure, its role in sexual function and its composition and function in the transgender population. Results The LM is highly neurovascular and engorges with blood with sexual stimulation. The structural changes are influenced by hormone levels. Perception of normal appearance varies by cultural and societal norms, influencing procedures performed in the area. Due to the histological composition of the LM, it has many manifestations of dermatological diseases. The LM is also susceptible to infectious, neoplastic, drug-induced, inflammatory, autoimmune and other systemic diseases. Limited information exists on LM piercing and tattoos. The size discrepancies of the LM may cause psychological distress, with conflicting research on its impact on sexual sensitivity or function. Labial procedures such as labiaplasty may enhance sexual satisfaction while female genital mutilation may reduce sexual satisfaction. There is a lack of comprehensive documentation of techniques of LM creation in transgender women and a lack of long-term follow-up studies post-vaginoplasty. The lymphatic structure within the LM is poorly understood, emphasizing the need for further research. Conclusions The labia minora is important for arousal and sexual function and its changes over time is dependent on hormone levels. The appearance and structure drive the kinds of labial procedures that are conducted and significantly affects sexual health. There is a need for further studies of the labia minora to understand its complexities and evolution. Disclosure No.

A comparative study to evaluate the efficacy of Kushthagna Mahakashaya and Aaraghwadadi Gana along with local application of Karanjadi Taila in the management of Eka-Kushta w.s.r. to Psoriasis

Introduction: Eka-Kushta is one among 11 varieties of Kushdra Kushta which resembles psoriasis clinically. It is one of the most common dermatological diseases, affecting up to 1-3% of the world’s and 0.44-2.8% of Indian population. Currently the treatment available for the management of psoriasis include topical therapy, photo therapy, corticosteroids, etc having their own limitations. Thus, there is a need for safe, effective, and sustainable medicine for the management. Methodology: The clinical study was done on 45 subjects of both genders, between the age group of 18-58 years who were randomly assigned into 3 groups (15 patients in each group) namely - Group A (Kushthaghna Mahakashyay and Karanjadi Taila), Group B (Aaraghwadadi Gana and Karanjadi Taila), and Group C (Placebo). Result: Outcome of the treatment after 45 days was statistically extremely significant in the remission of the symptoms of Eka-Kushta in most of the subjective and objective parameters. Discussion: Group A, treatment was found to be effective in Matsyashalopam, Kandu, Auspitz Sign, Candle grease sign, Koebner’s phenomenon, and PASI Score and the result was very significant in Aswedanama and Vruttam. Group B, treatment regimen was found to be effective in Matsyashalopam, Kandu, and Auspitz Sign, Candle grease sign, Koebner’s phenomenon, and PASI Score and the result was very significant in Aswedanama, Vruttam. Group C, treatment regimen was found to be effective in Matsyashalopam and the result was insignificant in Kandu, Aswedanama, Vruttam, Krishna Varna, Auspitz Sign, Candle grease sign, Koebner’s phenomenon, and PASI Score.

Autoimmune Connective Tissue and Dermatologic Diseases in Children with Autism Spectrum Disorder

Autoimmune Connective Tissue and Dermatologic Diseases in Children with Autism Spectrum Disorder