Inflammatory Skin Condition Research Articles

The role of diet in managing hidradenitis suppurativa: a review of current evidence and future directions.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition wish a complex pathogenesisinfluenced by multiple factors, including diet. This manuscript summarizes current literature onthe potential role of diet in HS management.Various dietary interventions, including the Mediterranean diet, elimination diets and specific nutrient supplementation, have shown promise in individual cases and observational studies. However, the heterogeneous nature of HS and the lack of controlled prospective studies limit the ability to make general dietary recommendations. Demographic factors influencing dietary habits and HS prevalence are also discussed. While food quality appears to be a crucial factor, more research is needed to establish definitive links between specific dietary components and HS outcomes. Future controlled clinical trials are necessary to develop evidence-based dietary guidelines for HS patients, considering individual variability and demographic factors.

Lawsone attenuates acute low dose ethanol-induced skin inflammation in A431 epidermoid carcinoma skin cells and its possible mechanisms in targeting interleukin (IL)-1α in silico

Standard treatment for acute skin inflammatory conditions comes with unwanted side effects. Traditionally, Lawsonia inermis has been used to treat skin-related ailments, with lawsone as the main active phytochemical is predicted to inhibit a skin pro inflammatory cytokine, IL-1α. This study is aimed to evaluate the anti- inflammatory effect of lawsone in acute ethanol-induced skin inflammatory condition in vitro, by targeting IL-1α in silico. Basically, the IC50 of lawsone on human epidermoid carcinoma cell line (A431) was obtained by using MTT proliferation assay, followed by acute low dose ethanol-induced inflammatory skin condition on A431 cells to determine cell viability. Next, molecular docking study was done by utilizing Autodock Vina software, and further analyzed by ProteinsPlus and PyMol softwares. Meaningful interaction that exist in the binding of lawsone to IL-1α was determined by molecular docking results comparison with two other compounds (kirenol and curcumin diglucoside). In vitro study showed the IC50 of lawsone in low cytotoxicity level at 150 µM. Skin anti-inflammatory assay indicated that lawsone has highly significant (p<0.05) anti-inflammatory activity at 9.375 µM at low concentration, but not effective at higher concentrations (more than 18.75 µM). In silico studies indicated binding of lawsone to IL-1α with top binding affinity of -5.2 kcal/mol, at binding residues of Asp65 and Ile68. Docking comparison analysis to determine meaningful interaction comparison indicated three key IL-1α binding residues common to most tested compounds, such as Ile68 and Asp65 thus supported the predicted mechanistic pathway. This highlighted lawsone potential as a future skin anti-inflammatory agent with minimal toxicity.

A Narrative Review of the IL-18 and IL-37 Implications in the Pathogenesis of Atopic Dermatitis and Psoriasis: Prospective Treatment Targets.

Atopic dermatitis and psoriasis are prevalent inflammatory skin conditions that significantly impact the quality of life of patients, with diverse treatment options available. Despite advances in understanding their underlying mechanisms, recent research highlights the significance of interleukins IL-18 and IL-37, in Th1, Th2, and Th17 inflammatory responses, closely associated with the pathogenesis of psoriasis and atopic dermatitis. Hence, IL-18 and IL-37 could potentially become therapeutic targets. This narrative review synthesizes knowledge on these interleukins, their roles in atopic dermatitis and psoriasis, and emerging treatment strategies. Findings of a literature search up to 30 May 2024, underscore a research gap in IL-37-targeted therapies. Conversely, IL-18-focused treatments have demonstrated promise in adult-onset Still's Disease, warranting further exploration for their potential efficacy in psoriasis and atopic dermatitis.

Challenges in Adult Acne and the Role of Skin Care in Managing the Condition.

Acne vulgaris is a complex, multifactorial, inflammatory skin condition. Although frequently presented at dermatology clinics, the literature on adult acne is scarce, particularly concerning skin barrier function and management. We aimed to provide insights into the role of skin barrier integrity in adult acne patients and the role of cleansers and moisturizers as adjunctive to treating and maintaining adult acne.   Methods: A panel of eight dermatologists who treat adult patients with acne developed a consensus paper on the role of skin barrier function and skin care in adult acne management. The modified Delphi method comprised a face-to-face meeting and online follow-up to discuss the results of a scoping literature review. Drawing from their experience and opinions, they agreed on seven consensus statements.   Results: Epidermal barrier dysfunction plays a vital role in acne pathogenesis and asymmetrically impacts adult female acne. Erythema, pruritus, peeling, and xerosis are common adverse effects of first-line acne treatment options and, if not appropriately counseled and managed, can exacerbate, leading to regimen nonadherence and poor patient experience and outcomes. Improving patient knowledge of comprehensive acne treatments, including quality adjunctive cleansers and moisturizers, may maximize regimen efficacy and provide patients with personalized and successful acne treatment and maintenance tools. J Drugs Dermatol. 2024;23(8):674-679.     doi:10.36849/JDD.8471.

Pro-inflammatory activity of Cutibacterium acnes phylotype IA1 and extracellular vesicles: An invitro study.

Acne is a chronic inflammatory skin condition that involves Cutibacterium acnes (C. acnes), which is classified into six main phylotypes (IA1, IA2, IB, IC, II and III). Acne development is associated with loss of C. acnes phylotype diversity, characterised by overgrowth of phylotype IA1 relative to other phylotypes. It was also shown that purified extracellular vesicles (EVs) secreted by C. acnes can induce an acne-like inflammatory response in skin models. We aimed to determine if the inflammatory profile of EVs secreted by C. acnes phylotype IA1 from an inflammatory acne lesion was different from C. acnes phylotype IA1 from normal skin, thus playing a direct role in the severity of inflammation. EVs were produced invitro after culture of two clinical strains of C. acnes phylotype IA1, T5 from normal human skin and A47 from an inflammatory acne lesion, and then incubated with either human immortalised keratinocytes, HaCaT cells, or skin explants obtained from abdominoplasty. Subsequently, quantitative PCR (qPCR) was performed for human β-defensin 2 (hBD2), cathelicidin (LL-37), interleukin (IL)-1β, IL-6, IL-8, IL-17α and IL-36γ, and ELISA for IL-6, IL-8 and IL-17α. We found that EVs produced invitro by C. acnes derived from inflammatory acne lesions significantly increased the pro-inflammatory cytokines and anti-microbial peptides at both transcriptional and protein levels compared with EVs derived from normal human skin. We show for the first time that C. acnes EVs from inflammatory acne play a crucial role in acne-associated inflammation invitro and that C. acnes phylotype IA1 collected from inflammatory acne lesion and normal skin produce different EVs and inflammatory profiles invitro.

Molybdenum Nanoparticles Alleviate MC903-Induced Atopic Dermatitis-Like Symptoms in Mice by Modulating the ROS-Mediated NF-κB and Nrf2 /HO-1 Signaling Pathways.

Atopic dermatitis (AD) is a chronic inflammatory skin condition that can affect individuals of all ages. Recent research has shown that oxidative stress plays a crucial role in the development of AD. Therefore, inhibiting oxidative stress may be an effective therapeutic approach for AD. Nano-molybdenum is a promising material for use as an antioxidant. We aimed to evaluate the therapeutic effects and preliminary mechanisms of molybdenum nanoparticles (Mo NPs) by using a murine model of chemically induced AD-like disease. HaCaT cells, a spontaneously immortalized human keratinocyte cell line, were stimulated by tumor necrosis factor-alpha /interferon-gamma after pre-treatment with Mo NPs. Reactive oxygen species levels, production of inflammatory factors, and activation of the nuclear factor kappa-B and the nuclear factor erythroid 2-related factor pathways were then evaluated. Mo NPs was topically applied to treat a murine model of AD-like disease induced by MC903, a vitamin D3 analog. Dermatitis scores, pruritus scores, transepidermal water loss and body weight were evaluated. AD-related inflammatory factors and chemokines were evaluated. Activation of the nuclear factor kappa-B and nuclear factor erythroid 2-related factor / heme oxygenase-1 pathways was assessed. Our data showed that the topical application of Mo NPs dispersion could significantly alleviate AD skin lesions and itching and promote skin barrier repair. Further mechanistic experiments revealed that Mo NPs could inhibit the excessive activation of the nuclear factor kappa-B pathway, promote the expression of nuclear factor erythroid 2-related factor and heme oxygenase-1 proteins, and suppress oxidative stress reactions. Additionally, they inhibited the expression of thymic stromal lymphopoietin, inflammatory factors, and chemokines, thereby alleviating skin inflammation. Mo NPs present a promising alternative treatment option for patients with AD as they could address three pivotal mechanisms in the pathogenesis of AD concurrently.

Safety and Tolerance Evaluation of a Suncare Product in Ethnically Diverse Children With Atopic Dermatitis-Prone Skin

Atopic Dermatitis (AD) is a common chronic inflammatory skin condition, with high prevalence in children. Sun protection is important for children with eczema and AD-prone skin, yet many sunscreens can cause skin irritation due to their formulations. In this study, we evaluated the safety and tolerance of an SPF 50 sunscreen in ethnically diverse children with a history of AD over 4 weeks of product use. A total of 45 children from diverse racial/ethnic backgrounds, aged 3 to 12 years old with skin phototypes I-VI, plus a history of eczema and perceived sensitive skin completed the study. All participants applied sunscreen daily on the face and body, at least 15 minutes prior to sun exposure and as needed. After 4 weeks, evaluations were performed by a dermatologist and by participants for tolerability. Product performance questionnaires were also completed by parents/guardians of pediatric participants. After 4 weeks of sunscreen application, tolerability assessments of skin dryness, peeling, erythema, and edema were all absent in children participants. Parent/guardian evaluations of sunscreen tolerability for their child also revealed no perceived skin issues. These results were consistent with no adverse event being observed throughout the study. Parents/guardians reported that sunscreen application on children was smooth and even, with the absence of a white cast appearance on children with skin of color. We conclude from this study that this SPF 50 sunscreen is safe to use in ethnically diverse children with a history of AD and sensitive skin. J Drugs Dermatol. 2024;23(8):669-673.  doi:10.36849/JDD.8282.

Helicobacter pylori infection in psoriatic patients and its relation to psoriasis severity: Cross Sectional Study.

Psoriasis is a prevalent inflammatory skin condition that can be recognized by silvery-white scales on plaques and erythematous papules, despite the fact that psoriasis appears to have multiple causes. Helicobacter pylori (H. pylori) has been investigated recently as a potential infectious etiological component. The objective of the study was to evaluate the prevalence of H. pylori infection in psoriatic patients compared to that of healthy controls and determine whether the degree of psoriasis and H. pylori infection were related. The dermatology, venerology, and andrology department at South Valley University Outpatient Clinic carried out this cross-sectional study. Psoriatic patients of both sexes and ages were included. In addition to the control group, H. Pylori antigen was measured from psoriatic and control groups by using H. pylori stool antigen-enzyme linked immunosorbent assay (HpSA-ELISA), a test for H. pylori stool antigen. More than 20ng/mL of antigen proved positive, or less than 15ng/mL proved negative. There was a significant difference between psoriatic patients and control regarding H. pylori infection (p=0.046): (30.66%) positive in controls, (45.33%) positive in psoriatic patients. Both groups were matched for age (p=0.908), that is, the mean age of psoriatic patients was 37.44±15.79 years, and the control group was 37.15±15.15 years. Twenty-five psoriatic patients in each group: mild, moderate, and severe psoriasis according to the Psoriasis Area Severity Index (PASI) score. No significant correlation between H. pylori infection and PASI, age, or duration of illness in psoriatic patients. Patients with psoriasis had greater rates of H. pylori infection but didn't affect the severity of psoriasis.

The Efficacy and Safety of Biosimilars in Hidradenitis Suppurativa: A Comprehensive Review.

Hidradenitis Suppurativa (HS), also known as Acne Inversa, is a chronic, recurrent inflammatory skin condition primarily affecting apocrine gland-bearing areas, such as the axilla and groin. Characterized by painful nodules, abscesses, and scarring, and has a profound psychological impact on patients. Current treatments aim to manage symptoms and prevent new lesions with a combination of non-pharmacological and pharmacological approaches. Emerging biosimilars, which replicate the efficacy and safety profiles of known biologics at a lower cost, offer new options for treating this debilitating cutaneous disorder. The review summarizes recent studies to explain the role of biosimilars in HS, emphasizing their potential to expand effective treatment options.

The use of azelaic acid in the reduction of acne vulgaris and post-inflammatory hyperpigmentation. Case report

Acne vulgaris is considered as one of the most common skin disorders. Its etiopathogenesis is based mainly on sebaceous gland overactivity, the influence of hormones, the presence of Cutibacterium acnes bacteria, abnormal keratinization of the outlets of the hair follicles and sebaceous glands, genetic factors and immunological disorders. Post-inflammatory hyperpigmentation occurs as a consequence of inflammatory skin conditions, such as acne vulgaris, and other similar diseases. They arise as a result of persistent inflammation, which stimulates melanocytes to synthesize melanin. The aim of this study was to evaluate the efficacy of 30% azelaic acid in a 25-year-old man with symptoms of acne vulgaris and post-inflammatory hyperpigmentation.

Ketoconazole Shampoo for Seborrheic Dermatitis of the Scalp: A Narrative Review.

Seborrheic dermatitis (SD) is a common inflammatory skin condition characterized by itchy, sensitive patches of greasy, flaky skin in areas rich in sebaceous glands, such as the scalp. Cases range from asymptomatic to debilitating, with effective treatment in severe cases proving crucial to patient quality of life. Ketoconazole shampoo is a topical antifungal that is a promising treatment option for individuals affected by this condition.Numerous trials display significant improvement in irritation and scaling of scalp seborrheic dermatitis (SSD) with ketoconazole shampoo treatment. Most studies also report optimally low relapse rates as well as little to no side effects, including rare skin irritation that resolves with cessation of the drug. Based on these findings, ketoconazole shampoo seems to be a safe and effective treatment for SSD.The present investigation reviews knowledge and research regarding ketoconazole shampoo as a treatment for SSD for physician consideration in the clinical setting.

Assessing the Potential Diagnostic Value of Indonesian Local Allergen Skin Prick Testing (SPT) for Cow’s Milk Allergy among Atopic Dermatitis Patients

Background: Atopic dermatitis (AD) is a multifactorial chronic, frequently recurrent, inflammatory skin condition. The development of IgE-mediated food allergies and food sensitivity are both associated with atopic dermatitis. Cow’s milk allergy (CMA) caused the most common hypersensitivity reaction during childhood; however, the prevalence in adults is around 0.5%. Patients with AD use the Skin Prick Test (SPT) to evaluate the specific sensitization process. Purpose: This study aimed to assess cow's milk allergy among adult AD patients using local allergen extract SPT, standard SPT, and specific IgE (sIgE), as well as evaluating the conformity and relevance of the test results. Methods: Using consecutive sampling technique, the study was conducted twice on 45 adult AD patients with a one-week interval between administrations. Result: Local cow's milk SPT showed 4 positive results, and standard SPT showed 5. No sIgE test was positive. Local SPT was negative for 86.67% of individuals without a history of suspected cow's milk allergies. Standard SPT results were positive for 2.22% of individuals with a history of suspected cow's milk allergies and negative for 86.67% of those without. The relevance between local and standard SPT was shown to be substantial (k = 0.384, p = 0.000). Conclusion: The result of the local cow’s milk SPT and the patient’s history had good conformity, and the relevance with standard SPT was significant in diagnosing cow’s milk allergy among AD patients.

EMPATHY Life in Psoriasis: Embracing Patients' Well-Being in Their Journey of Moderate-to-Severe Psoriasis.

Background: Psoriasis is a chronic inflammatory skin condition that affects millions of individuals worldwide, impacting their physical and emotional well-being. The management of psoriasis requires effective communication and a strong physician-patient relationship. Objective: We aim to develop a novel algorithm to enhance patient well-being and care in moderate-to-severe psoriasis, considering the time constraints that dermatologists have in public hospitals. Methods: This project employed a multidisciplinary approach, involving collaboration between 14 experienced dermatologists (referred to as Key Opinion Leaders: KOLs) and a psychologist. During three separate meetings (an initial virtual session, a face-to-face meeting, and a final virtual meeting), an algorithm (Embracing Patients' Well-being in their Journey of Moderate-to-Severe psoriasis: EMPATHY), describing the patient's reception through the entire first visit and follow-up visits, was developed and refined. Results: The EMPATHY algorithm provides a step-by-step approach from the moment the patient arrives at reception, through the first visit and on to subsequent visits. This algorithm fills a critical gap in the existing guidelines by specifically addressing how to foster empathy during psoriasis patient visits within time-limited consultations. The algorithm outlines patient-centered strategies at each visit. Key aspects include creating a welcoming environment, active listening, respecting privacy, tailoring communication styles, and managing patient expectations. Conclusions: The EMPATHY algorithm represents a novel and promising approach to improving patient care and well-being in moderate-to-severe psoriasis. Developed together by dermatologists and a psychologist, this algorithm offers healthcare providers practical guidance for managing both initial and follow-up patient visits. While further validation is necessary, the potential for adapting the EMPATHY algorithm to diverse healthcare settings and patient populations holds promise for improving patient outcomes across various chronic conditions.

Role of Trifarotene in the Management of Acne in Indian Patients: Insights From an Indian Dermatology Experts' Meeting.

Acne vulgaris, a prevalent inflammatory skin condition, significantly impacts individuals worldwide, particularly adolescents and adults. Its chronic nature, associated sequelae, and psychosocial impact underscore the substantial burden it poses. Current treatment guidelines primarily address facial acne, with limited guidance on managing truncal acne. Personalized approaches are increasingly recognized as essential for tailoring treatments to individual patient needs. This review integrates insights from an Indian Dermatology Experts' Meeting, featuring perspectives from nine leading dermatologists. Discussions centered on analyzing acne's burden, its effects on quality of life (QoL), unmet needs in management, trifarotene's role in Indian therapy, anticipated challenges, and the importance of ancillary care. The experts highlighted acne's profound impact on patients' QoL and identified gaps in current management guidelines, especially concerning truncal acne. Trifarotene, a fourth-generation topical retinoid approved by the FDA and Drug Controller General of India (DCGI) for facial and truncal acne, demonstrated safety and efficacy across age groups. This synthesis of expert perspectives underscores the need for personalized acne management. Trifarotene emerges as a promising therapeutic option but challenges remain, particularly in optimizing ancillary care to minimize treatment-related adverse effects. Addressing these issues will enhance treatment outcomes and patient satisfaction in acne management, emphasizing the importance of tailored approaches in clinical practice.

Newly Developed Semi-Solid Formulations Containing Mellilotus officinalis Extract: Characterization, Assessment of Stability, Safety, and Anti-Inflammatory Activity.

Melilotus officinalis has been traditionally used as an anti-inflammatory agent; nevertheless, a comprehensive evaluation of its efficacy and safety and comparison with standard drugs are lacking. Taking into consideration concerns with current therapies, like efficacy limitations, side effects, and resistance, we aimed to develop a natural gel and cream based on Melilotus officinalis extract and explore their anti-inflammatory potential. After the chemical analysis of the extract confirmed the presence of coumarin, p-coumaric acid, gallic acid, and quercetin, formulations were prepared and subjected to physical and chemical stability evaluations over 6 months. The safety potential was tested in rats, while the anti-inflammatory activity was assessed both via in silico tests and in a rat model of inflammation. The examined formulations showed stable physical characteristics at the defined storage conditions and did not exert any sign of adverse skin reaction. The gel formulation exhibited a remarkable effect in inflammation reduction comparable with hydrocortisone. The in silico results suggest that coumarin, p-coumaric, and gallic acid bind to COX-1 and COX-2 with a lower affinity compared to diclofenac. On the other hand, quercetin demonstrated comparable inhibitory activity and stronger interaction compared to the control drug. Our results indicate that the examined formulations are stable and safe and may be promising dermal products for the alleviation of inflammatory skin conditions.

Disease modification in chronic spontaneous urticaria.

Chronic spontaneous urticaria (CSU) is a debilitating, inflammatory skin condition characterized by infiltrating immune cells. Available treatments are limited to improving the signs and symptoms. There is an unmet need to develop therapies that target disease-driving pathways upstream of mast cell activation to inhibit or delay the progression of CSU and associated comorbidities. Here, we aim to define disease modification due to a treatment intervention and criteria that disease-modifying treatments (DMTs) must meet in CSU. We have defined disease modification in CSU as a favorable treatment-induced change in the underlying pathophysiology and, therefore, the disease course, which is clinically beneficial and enduring. A DMT must fulfil the following criteria: (1) prevents or delays the progression of CSU, (2) induces long-term, therapy-free clinical remission, which is the sustained absence of CSU signs and symptoms without the need for treatment, and (3) affects the underlying mechanism of CSU, as demonstrated by an effect on disease-driving signals and/or a biomarker. DMTs in CSU should slow disease progression, achieve long-lasting disease remission, target disease-driving mechanisms, reduce mast cell-activating IgE autoantibodies, target cytokine profile polarization, and normalize the gut microbiome and barrier. Treating CSU at the immune system level could provide valuable alternatives to pharmacotherapy in CSU management. Specific DMTs in CSU are yet to be developed, but some show potential benefits, such as inhibitors of Bruton's Tyrosine Kinase, IL-4 and IL-13. Future therapies could prevent CSU signs and symptoms, achieve long-term clinical benefits after discontinuing treatment, and prevent associated concomitant disorders.

Beyond the classic players: Mas-related G protein-coupled receptor member X2 role in pruritus and skin diseases.

Chronic spontaneous urticaria (CSU), atopic dermatitis (AD), psoriasis and rosacea are highly prevalent inflammatory skin conditions which impose a significant burden on patients' quality of life. Their pathophysiology is likely multifactorial, involving genetic, immune and environmental factors. Recent advancements in the field have demonstrated the key role of mast cells (MC) in the pathophysiology of these conditions. The Mas-related G protein-coupled receptor X2 (MRGPRX2) has emerged as a promising non-IgE-mediated MC activation receptor. MRGPRX2 is predominately expressed on MC and activated by endogenous and exogenous ligands, leading to MC degranulation and release of various pro-inflammatory mediators. Mounting evidence on the presence of endogenous MRGPRX2 agonists (substance P, cortistatin-14, LL37, PAMP-12 and VIP) and its high expression among patients with CSU, AD, rosacea, psoriasis and chronic pruritus emphasizes the pathogenic role of MRGPRX2 in these conditions. Despite the currently available treatments, there remains a pressing need for novel drug targets and treatment options for these chronic inflammatory skin conditions. Here, we reviewed the pathogenic role of MRGPRX2 and its potential as a novel therapeutic target and provided an update on future research directions.

Successful Tralokinumab Treatment for Hand and Foot Atopic Dermatitis in a Patient with Skin of Color: A Case Report

Atopic dermatitis (AD) is a common chronic inflammatory skin condition that disproportionately affects skin of color patients. New targeted biological therapies such as tralokinumab are available for the management of AD, but real-world evidence of their clinical effectiveness in skin of color patients is limited, particularly in patients with difficult-to-treat hand and foot involvement. In this report, we present a case of recalcitrant atopic dermatitis with hand-foot involvement in a skin of color patient successfully treated with tralokinumab.

Spectrum of Inpatient Pediatric Dermatology Cases at a Tertiary Health Care Centre in South India.

Background Dermatologists and pediatricians commonly encounter pediatric dermatology cases in their clinical practice, and the number has risen for the past decade. While numerous studies have addressed adult inpatient dermatology cases, there is a lack of data on the same for the pediatric population. Aim The study aimed to investigate the spectrum and outcomes of inpatient pediatric dermatology cases at a tertiary health care center. Methods This was a hospital-based, cross-sectional study that included children under the age of 16 years with primary skin disorders who were admitted to the pediatric dermatology unit. Patients were categorized into six groups based on their provisional diagnosis for better analysis. Results A total of 105 children were admitted, with a male-to-female ratio of 1.2:1. The average age of admitted children was 5.8 years, with the majority belonging to the school-going age group, accounting for 44% of the patients. Conclusion Inflammatory skin conditions like childhood psoriasis and erythroderma were the most common group of disorders presented to us, followed by hereditary conditions like keratinization disorders and mechanobullous disorders. Pediatric dermatology emergencies (PDEs) require an inter-professional approach for timely intervention and management.

The Role of Line-Field Confocal Optical Coherence Tomography in Detecting Extramammary Paget Disease Recurrences: A Pilot Diagnostic Study.

Extramammary Paget disease (EMPD) is an uncommon adenocarcinoma of apocrine gland-rich areas, presenting significant diagnostic challenges due to its nonspecific clinical appearance and frequent misidentification as benign, inflammatory skin conditions. Traditional diagnostic methods such as biopsy are invasive and uncomfortable, often required repeatedly due to high recurrence rates. Dermoscopy and non-invasive imaging techniques have been used but provide limited diagnostic accuracy due to their constraints in depth penetration and resolution. Recent advancements in imaging technologies, such as line-field confocal optical coherence tomography (LC-OCT), show promise in enhancing diagnostic precision while minimizing invasive procedures. LC-OCT merges high-resolution imaging with deep penetration capabilities, capturing detailed horizontal and vertical skin images akin to histopathology. This study evaluated the diagnostic performance of LC-OCT in detecting EMPD and its recurrence in 17 clinically suspicious anogenital regions, belonging to six patients. Data were collected prospectively at the patient's bedside by an LC-OCT expert with poor training for EMPD, and, then, reviewed retrospectively by an independent LC-OCT expert with adequate training for EMPD and no concerns about time. The prospective examination yielded 64.7% accuracy (11 true results out of 17 total cases), 71.4% sensitivity (10 true positives out of 14 actual positives), and 33.3% specificity (1 true negative out of 3 actual negatives). The retrospective analysis achieved 94.1% accuracy (16 true results out of 17 total cases), 100% sensitivity (14 true positives out of 14 actual positives), and 66.7% specificity (2 true positives out of 3 actual positives), with the only false positive case being a difficult-to-diagnose concomitant presentation of a lichen sclerosus et atrophicus. Despite the need for specialized training, our results suggest that LC-OCT represents a valuable tool for accurately identifying EMPD and improving its management by reducing unnecessary biopsies. Further studies are needed to standardize its clinical application.