Dermatology Outpatient Clinic Research Articles

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

Abstract Background Melasma is a common acquired pigmentary disorder that manifests as symmetric hyperpigmented macules and patches on the face, more frequently affecting women of reproductive age. Various underling risk factors have been implicated in the etiology of melasma including; Genetic factors, pregnancy, oral contraceptives, endocrine dysfunction, hormone treatments, cosmetic contact sensitivity and exposure to ultraviolet (UV) light. Management of melasma is a frustrating experience both for the treating doctors and patients because of its recurrent and often recalcitrant nature. Numerous therapeutic modalities have been tried for this condition such as hydroquinone, kligman’s formula (hydroquinone + steroid + tretinoin), kojic acid, azelaic acid, arbutin, ascorbic acid, chemical peels, lasers, tranexamic acid, rucinol, oligopeptides, silymarin, orchid extracts, and various botanical extracts with variable success rates. Objectives Our aim was to assess and compare the therapeutic effects of topical metformin solution 30% with microneedling versus topical tranexamic acid (4mg\ml) solution with microneedling in treating patients with facial melasma. Patients and Methods This is a split-face study included 35 patients with facial melasma. The patients recruited from the Outpatient Dermatology Clinic at Ain Shams University Hospitals. Topical metformin 30% solution with microneedling sessions were done for the right side of the face (4sessions - two weeks apart), and topical tranexamic acid solution (4mg/ml) with microneedling on the left side of the face (4 sessions – two weeks apart). The patients were followed up for 3 months. The response of treatment was evaluated by Hemi MASI score and Antera 3D camera. Results Our study revealed that both microneedling followed by topical metformin solution and microneedling followed by topical TXA solution were efficient in treatment of facial melasma as shown by significant decrease in h-MASI score and average melanin level assessed by Antera camera. Although statistically insignificant, the percentage of change in h- MASI score was more evident with TXA treatment than metformin treatment. The side effects were limited and transient in the form of erythema, burning sensation, and xerosis. The main problem with either treatment was the high relapse rate. Conclusion Both metformin and tranexamic acid applied topically following microneedling sessions led to statistically significant improvement of melasma according to Hemi MASI scores. Topical metformin appears to be a promising therapeutic option in the treatment of melasma without serious adverse effects.

The Efficacy of Intralesional Pentoxifylline Injection versus the Standard Intralesional Corticosteroid Injection in The Treatment of Alopecia Areata

Abstract Background Alopecia areata is a nonscarring skin disease affecting the scalp or other body parts. The etiology of AA is still controversial and various pathogenic causes are under investigation. Several treatment modalities are used in managing AA. Objective to evaluate the efficacy and safety of (PTX) injection in treatment of localized AA compared to intralesional corticosteroids TRA on 30 patients with multiple patches of AA. Patients and Methods The current study was a prospective intra-patient comparative controlled clinical trial. Patients were recruited form outpatient clinic of Dermatology, Ain Shams University Hospital in the period from November 2019 to May 2020. 30 Egyptian patients (11 males &19 females) with at least three patches were enrolled to the study. The diagnosis of AA patients enrolled in the study based on clinical signs. Results To sum up, both PTX and ILCS has good results in treatment of AA, as each of them has its own advantages. Corticosteroids are rapidly acting while PTX effects are delayed but increased progressively throughout consecutive sessions. So using corticosteroids in combination with PTX can augment each other and give better results. Conclusion Treatment of AA with intralesional PTX exerted significant increase in hair density, total hair count, terminal hair count and percentage of terminal hair which is evident after completion of the sessions. Treatment with ILCS exerted significant increase hair density, total hair count, terminal hair count and percentage of terminal hair after treatment. Comparison of both treatment modalities revealed slight better response with PTX compared to ILCS. In conclusion, the current study revealed that Intralesional combined administration of PTX and TRA can be beneficial for patients suffering from AA. Steroid showed a rapid response that could be maintained by adding PTX.

Impact of Psoriasis on Male Fertility: A Case-Control Study

Abstract Background Psoriasis is a common, chronic, relapsing skin disease, currently considered to be an immune mediated inflammatory disease. Several epidemiological studies have shown that patients with immune-mediated inflammatory diseases, including psoriasis, have a higher risk of developing comorbidities, such as cardiovascular disease, metabolic syndrome, diabetes and nonalcoholic fatty liver disease compared to the general population. Aim of the Work to assess gonadal function in psoriatic male patients to know the effect of psoriasis on fertility in these subjects. This evaluation was conducted on a hormonal and seminal background. Patients and Methods This case control study included 40 patients (20 with psoriasis & 20 healthy age and body mass index (BMI) matched controls). They were recruited from the dermatology out-patient clinic of Ain–Shams University Hospitals, during the period from November 2021 till April 2022. The study was approved by Research Ethical Committee of Ain Shams University (FMASU M S 667/2021) and fulfilled all the ethical aspects required for a human research. Results Twenty patients, with a mean age of 30.15 ± 8.04 years, fulfilled the inclusion criteria and were enrolled in our study. The mean BMI was 25.11 ± 3.02. The mean disease duration was 4 (2.5 – 8) years, and the mean PASI score at the time of enrollment 11.25 (5.1 – 15.8)., and. twenty healthy subjects, matched for age and BMI, were also enrolled as a control group Conclusion The evaluation of seminal fluid analysis and hormone profiles among psoriasis patients showed minor variability. However, it was evident that the levels of sex hormones were different in patients with psoriasis compared to healthy controls. Serum estradiol & SHBG levels were significantly increased among psoriasis patients relative to control group while, serum testosterone levels were significantly lower among psoriasis patients relative to control patients.

Clinical Spectrum of Dermatological Disorders at an Urban Health Center in East Delhi.

Dermatological disorders constitute a significant proportion of primary health care (PHC) setups. The pattern of dermatological disorders varies among different countries and different parts of the same country owing to climatic and geographical variations, level of education, access to health care, etc. To study the clinical spectrum of patients presenting with dermatological disorders at an urban health center (UHC) in East Delhi. To identify the various risk factors associated with dermatological disorders in study subjects. A total of 1,148 patients who reported skin diseases for the first time at the Dermatology Outpatient Clinic at UHC in East Delhi were recruited. Detailed demographic data, history, and examination and potential risk factors of skin diseases (socioeconomic status, level of education, occupation, comorbidities, and addictions) were recorded on a predesigned proforma. A total of 616 (53.7%) patients had infectious dermatoses and 532 (46.3%) had non-infectious dermatoses. Among the infectious dermatoses, fungal diseases (44.8%) were the most common followed by parasitic infections (31.17%) and bacterial infections (9.74%). Among the non-infectious group, eczematous disorders (28.01%) were the most common, followed by pigmentary disorders (21.62%) and acne (19.55%). A significant association between level of education, occupation, and comorbidities with the distribution of infectious and non-infectious dermatoses was found. As a significant proportion of patients with a vivid spectrum of dermatological disorders present at the PHC setups, therefore dermatologists supervise that specialty clinics should be held regularly at these centers along with the availability of all the basic investigations to aid diagnosis and management.

The Spectrum of Pediatric Skin Diseases: A Prospective Study in Sudan

Background: In line with the World Health Organization's (WHO) campaign to improve community dermatology services, research on the spectrum of pediatric skin diseases is crucial for both patients and policymakers. Identifying the spectrum of pediatric skin conditions among children visiting the Khartoum Dermatological Hospital's outpatient dermatology clinic was the goal of this study. Methods: Over six months, a prospective cross-sectional study including children (0–18 years old) was undertaken. Once the pertinent medical history and examinations were gathered, dermatologists made the diagnosis. Skin conditions were divided into several categories. The analysis of the data was done with the SPSS version 23. Results: A total of 320 children, with a male-to-female ratio of 1.1:1, were enrolled. Ten categories with 38 different skin diseases were established after diagnosis. Infections in 152 (47.5%), eczematous disorders in 89 (27.8%), and appendageal disorders in 19 (5.93%) children were the most prevalent conditions by group. Impetigo (37.5%), scabies (10.9%), and seborrheic dermatitis (10.6%) were the most frequently seen diseases. These illnesses most commonly afflicted the areas of the limbs (30%), face (20%), and scalp (18.7%). Papules in 148 (46%) and scales in 74 (23%) children were the most prevalent primary and secondary efflorescence, respectively. A clinical diagnosis was made in the majority (266 [83.1%]) of the cases. Conclusion: The most frequently observed group was infection. This demonstrates how crucial it is to maintain good personal and family hygiene, minimize overcrowded spaces, and promoting public health.

High-frequency ultrasound evaluation of morphea: Retrospective analytical study.

To date, there are no accepted outcome measures to monitor morphea, and consensus on specific monitoring criteria for morphea remains elusive. A few studies have assessed the criterion validity of skin ultrasound in morphea. So, in this study, we approach ultrasound findings in morphea lesions. This was a retrospective-analytical study conducted between December 2021 and May 2023. Patients were clinically evaluated at a dermatology outpatient clinic and then referred for high-frequency ultrasound (HF-US) evaluation and were selected to be included in this study. The lesions were confirmed by histopathology as well. Sonographic evaluations were performed on the lesion site and the symmetrical uninvolved other side. Dermal thickness and dermal echogenicities were recorded. Statistical analysis of group differences was performed by using the 2-tailed Student t-test. A p-value of less than 0.05 was considered statistically significant. Forty-one morphea lesions in the inflammatory phase of 27 patients were included in the study. The mean dermal thickness of morphea lesions was 1107.97±414.3 and the mean dermal thickness of the control side was 1094.65±331.06, The difference between these two variables was not statistically significant. The mean dermal density of lesions was 49.13±18.97 and the mean dermal density of the control side was 52.22±25.33. The difference between these two variables was not statistically significant. This study shows that HF-US indicated increasing dermal thickness and reducing the dermal density of the morphea lesions in the inflammatory phase confirmed with the histopathology.

Linguistic Validation and Reliability of the Croatian Version of the TOPICOP Questionnaire.

Background and Objectives: This study demonstrates the factor structure and reliability of the Croatian version of the TOPICOP (Topical Corticosteroid Phobia) questionnaire, thereby contributing to further validation and standardization of the measurement of topical corticophobia with dermatological patients or their parents, which directly affects patient or parent compliance, as well as the final therapeutic effect. Materials and Methods: The cross-sectional, observational study was conducted at the University Hospital Centre Split, Department of Dermatovenerology. The research involved inviting 120 participants (age 12-68) who attended the University Hospital Centre Split's Atopy School, patients examined in the Dermatology Outpatient Clinic of the University Hospital Centre Split and diagnosed with atopic dermatitis (AD) or allergic contact dermatitis (ACD), and parents or legal representatives of patients younger than 12 years old. The TOPICOP questionnaire consists of 12 items assessing the three different components of topical corticophobia (worries, beliefs, and behaviour). Respondents evaluated their perception of the correctness of each statement within 10 min of filling out the questionnaire on a four-point Likert scale. Results: The response rate was 94%, resulting in a sample of 113 respondents (109 adults and 4 children). Factor analysis yielded one common factor of relatively high reliability (Cronbach α = 0.85, 95% CI 0.81 to 0.89). No differences were found in questionnaire scores between male and female participants, nor between the parents/legal representatives of dermatological patients and other patients. Conclusions: This research contributes to further development of the appropriate measuring instrument, its practical application, and thus, the better recognition, resolution, and prevention of topical corticophobia as part of the better overall healthcare and treatment of chronic dermatological patients.

A dermoscopy case series of cutaneous metastases from breast cancer in Filipino females

AbstractThere is a limited number of dermoscopic images of cutaneous metastases from breast cancer. We report three cases of cutaneous metastases in Filipino females with breast cancer. They were referred to the Dermatology outpatient clinic with round, firm, nontender, erythematous nodules on the chest and trunk. Dermoscopic findings noted were linear, irregular, arborizing and polymorphic vessels, bright white lines at the periphery and white areas, homogenous yellow to yellow‐orange structureless areas with linear fissure‐like structures and irregular diffuse blue‐black pigmentation, multiple brown dots and globules, and pink homogeneous areas. The clinical presentation, dermoscopy, histopathology and immunohistochemistry findings were consistent with cutaneous metastases from breast cancer. Familiarity and knowledge of dermoscopic patterns will improve diagnostic accuracy and early recognition of cutaneous metastases.

The Prevalence of Body Dysmorphic Disorder in Outpatient Dermatology Clinics: A Systematic Review.

Body Dysmorphic Disorder (BDD) is a psychiatric condition involving a preoccupation with physical appearance disproportionate to physical findings, which are often absent altogether. Previously published data has estimated its prevalence at 11.3-11.9% approximately, across various medical specialties. No recent systematic reviews strictly related to dermatology clinics and the prevalence of BDD have been published. The goal of the review was to gather a pooled prevalence of BDD in outpatient dermatology clinics around the world and further underline the importance of its recognition and appropriate treatment. Twenty-one articles tackling BDD in outpatient cosmetic and general dermatology clinics were selected. Studies were graded based on the Newcastle-Ottawa Scale (NOS) and the Statistical Package for the Social Sciences software (SPSS) was used to a calculate a mean for the pooled prevalence, yielding a weighted mean prevalence of 12.5% among general dermatology patients and 25.01% among cosmetic dermatology patients. The mean prevalence of BDD among general dermatology patients fell within previously reported numbers. It was, however, markedly higher than previously reported in cosmetic dermatology patients, which we postulate could be due to dermatologists being at the forefront of non-invasive cosmetic procedures. As such, we conclude that given the high prevalence of BDD among dermatology patients, we highlight the importance of keeping a high index of suspicion of BDD among dermatologists, ways to uncover it in a clinical setting, and additional data showcasing the importance of psychiatric treatment of these patients for better outcomes, all while avoiding unnecessary interventions.

Clinical Observation on the Therapeutic Effect of Port-Wine Stains with Intravenous Injection of Hematoporphyrin Monomethyl Ether (HMME).

Hematoporphyrin monomethyl ether (HMME) is a promising photosensitizer for photodynamic therapy (PDT) and has found wide application in the treatment of port-wine stains (PWS). This study aims to observe and analyze the clinical efficacy and safety of HMME-PDT in the treatment of PWS patients. It also aims to evaluate the usefulness of color Doppler flow imaging (CDFI), an ultrasound technique for detecting blood flow in skin lesions, in assessing clinical efficacy. Thirty-three patients with PWS underwent HMME-PDT at our dermatology outpatient clinic between January 2019 and March 2020. Data on patient demographics, lesion location, lesion type (pink, purple, nodular thickening), treatment frequency, and pre- and post-treatment images were collected and retrospectively analyzed. CDFI was performed on three patients. All patients received intravenous HMME and underwent irradiation with 532 nm green LED light. Of these, 5 patients received 1 session of HMME-PDT, 14 received 2 sessions, 9 received 3 sessions and the remaining 5 patients received more than 3 sessions. Of the 33 patients, 9 were cured (27.27%), 10 showed improvement (30.30%), 11 experienced a reduction in symptoms (33.33%), and 3 showed no significant improvement (9.09%). Most patients reported local pain and oedema, and no systemic adverse effects were observed. Clinical efficacy correlated with lesion type and total number of treatment sessions. CDFI appears to be an excellent technique for assessing clinical efficacy. HMME-PDT is a safe and effective method for the treatment of PWS. CDFI examination appears to be a promising assessment tool. However, further validation with larger sample sizes is warranted.

Evaluation of the efficacy and safety of cold laser (Diode 808 nm) therapy in the treatment of localized plaque psoriasis: clinical, dermoscopic and ultrastructural study

Background Psoriasis is a chronic, recurring, and immune-mediated inflammatory skin disease. Throughout the period of the last few decades, phototherapy has become widely used in treating stable psoriatic lesions. For the treatment of psoriasis, several light/laser therapies with distinct modes of action have been developed. Cold laser therapy might be an effective therapeutic choice for localized plaque psoriasis. Objective To assess the safety and efficacy of cold laser therapy clinically and microscopically in localized plaque psoriasis treatment. Patients and methods 40 patients with localized mild plaque psoriasis were selected from the Dermatology and Venereology outpatient clinic–Tanta University Hospitals and enrolled in the clinical trial. They were treated by cold laser 808 nm wavelength (Endolaser 422, Enraf–nonious B.V. Rotterdam, Netherlands) one session for 10 min on each plaque twice weekly separated by 2 days until clinical cure or for a maximum of 8 weeks. Evaluation was done immediately after the last session by taking the average of three blinded dermatologists of the photos, the modified Psoriasis Area and Severity Index [mPASI], dermoscopic examination, patients’ satisfaction scale and histopathological and electron microscopic examination of punch biopsy specimens taken before and after the end of treatment from psoriatic lesions in four patients only. Results There was a statistically significant clinical improvement after the end of treatment compared with before treatment as 16 patients (40%) showed excellent improvement, 8 patients (20%) showed good improvement, 9 patients (22.5%) showed mild improvement, and 7 patients (17.5%) showed poor improvement. As regard mPASI, a statistically significant decrease in mPASI was found after the end of treatment (P<0.001). Regarding dermoscopic examination, a statistically significant reduction in the percentage of patients showing dermoscopic red dots and white scales after the end of treatment (P<0.01). As regard the patients’ satisfaction scale, 82.5% of patients were satisfied from the results. Histopathological and ultrastructural evaluation revealed normalization of the psoriatic microscopic changes with cold laser. Conclusion The use of cold laser therapy for the management of localized mild plaque psoriasis is safe, tolerable, effective, and can be used as an alternative therapy for psoriasis.

Welche Faktoren beeinflussen die Teilnahme am gesetzlichen Hautkrebsscreenings in Deutschland?

Due to increasing skin cancer incidence, Germany implemented a statutory nationwide routine skin cancer screening (rSCS) in 2008. The present study aims (1) to analyze which patient factors are associated with the participation in rSCS in Germany and (2) to investigate reasons for nonparticipation. Participants and nonparticipants of rSCS (≥35years) were recruited in routine care in nine dermatological outpatient clinics. Reasons for (non)participation, knowledge about skin cancer as well as clinical and socioeconomic data were obtained. Stratified by groups, descriptive analyses and binary logistic regression analyses for associations with participation were performed. Of the 294 rSCS participants and 162 nonparticipants, 46.5% were male with a mean age of 54.5 ±12.7years. In total, 87.1% had sunburns in childhood and 47.1% used sunbeds before. Higher age, female gender, previous sunbed use, and concern for and knowledge of skin cancer were significantly associated with previous rSCS participation. Of the nonparticipants, 46% were unaware of the option for free rSCS and 40% justified their nonparticipation on the basis of feeling healthy. The reasons for nonparticipation in rSCS, such as sociodemographic characteristics and risk behavior, should be known in order to optimize rSCS programs.

Which factors influence the participation in statutory skin cancer screenings in Germany?

Due to increasing skin cancer incidence, Germany implemented a statutory nationwide routine skin cancer screening (rSCS) in 2008. The present study aims (1) to analyze which patient factors are associated with the participation in rSCS in Germany and (2) to investigate reasons for nonparticipation. Participants and nonparticipants of rSCS (≥35years) were recruited in routine care in nine dermatological outpatient clinics. Reasons for (non-)participation, knowledge about skin cancer as well as clinical and socioeconomic data were obtained. Stratified by groups, descriptive analyses and binary logistic regression analyses for associations with participation were performed. Of the 294 rSCS participants and 162 non-participants, 46.5% were male with a mean age of 54.5 ±12.7years. In total, 87.1% had sunburns in childhood and 47.1% used sunbeds before. Higher age, female gender, previous sunbed use, and concern for and knowledge of skin cancer were significantly associated with previous rSCS participation. Of the non-participants, 46% were unaware of the option for free rSCS and 40% justified their nonparticipation on the basis of feeling healthy. The reasons for nonparticipation in rSCS, such as sociodemographic characteristics and risk behavior, should be known in order to optimize rSCS programs.

Acute myeloid leukemia manifesting as pruritus: a case report

Acute myeloid leukemia (AML) is considered a rare malignancy of the stem cell precursors in the bone marrow, resulting in only 1.2% of new malignancy diagnoses in the United States. Pruritus is a frequent complaint for dermatology providers, averaging up to 54% of adult outpatient dermatologic patients. Dermatologic manifestations, specifically pruritus, are not common in AML; however, AML is a potentially lethal malignancy that should be considered. Here, the author describes a case of a male patient with no past malignancy history. He presented to the outpatient dermatology clinic with complaints of generalized pruritus for 1–2 weeks. He was diagnosed with severe anemia and subsequently AML after direct admission to local inpatient hematology/oncology specialists. This case illustrates the importance of considering malignancy, specifically leukemia and AML, as a differential in patients with generalized pruritus.

Do complaints related to vitiligo affect sexual quality of life and marital adjustment?

The authors aimed at evaluating the effect of vitiligo on female sexual function and Dyadic Adjustment in a hospital-based study as gender negatively affected the marital quality of vitiligo patients, more in women. A total of 153 patients who applied to the dermatology outpatient clinic of a tertiary university hospital were interviewed. However, 120 vitiligo patients who were married and had a sexually active partner and suitable the inclusion criteria were included in the study. It is seen that the mean score of the DAC is 43.13±5.11, and the mean score of the SQOL-F is 52.57±5.39. Vitiligo has a negative effect on a woman’s sexual life and Dyadic Adjustment. Early identification of sexual problems in vitiligo patients and planning their future course of management can aid in improving the marital adjustment and quality of life.

Integrated plasma metabolomic and cytokine analysis reveals a distinct immunometabolic signature in atopic dermatitis.

Disease models for atopic dermatitis (AD) have primarily focused on understanding underlying environmental, immunologic, and genetic etiologies. However, the role of metabolic mechanisms in AD remains understudied. To investigate the circulating blood metabolomic and cytokine profile of AD as compared to healthy control patients. This study collected plasma from 20 atopic dermatitis with moderate-to-severe itch (score of ≥5 on the itch Numeric Rating Scale and IGA score ≥3) and 24 healthy control patients. Mass-spectrometry based metabolite data were compared between AD and healthy controls. Unsupervised and supervised machine learning algorithms and univariate analysis analyzed metabolic concentrations. Metabolite enrichment and pathway analyses were performed on metabolites with significant fold change between AD and healthy control patients. To investigate the correlation between metabolites levels and cytokines, Spearman's rank correlation coefficients were calculated between metabolites and cytokines. Patients were recruited from the Johns Hopkins Itch Center and dermatology outpatient clinics in the Johns Hopkins Outpatient Center. The study included 20 atopic dermatitis patients and 24 healthy control patients. Fold changes of metabolites in AD vs healthy control plasma. In patients with AD, amino acids isoleucine, tyrosine, threonine, tryptophan, valine, methionine, and phenylalanine, the amino acid derivatives creatinine, indole-3-acrylic acid, acetyl-L-carnitine, L-carnitine, 2-hydroxycinnamic acid, N-acetylaspartic acid, and the fatty amide oleamide had greater than 2-fold decrease (all P-values<0.0001) compared to healthy controls. Enriched metabolites were involved in branched-chain amino acid (valine, leucine, and isoleucine) degradation, catecholamine biosynthesis, thyroid hormone synthesis, threonine metabolism, and branched and long-chain fatty acid metabolism. Dysregulated metabolites in AD were positively correlated cytokines TARC and MCP-4 and negatively correlated with IL-1a and CCL20. Our study characterized novel dysregulated circulating plasma metabolites and metabolic pathways that may be involved in the pathogenesis of AD. These metabolic pathways serve as potential future biomarkers and therapeutic targets in the treatment of AD.

PSYCHO-SOCIAL IMPACT AND QUALITY OF LIFE AMONG PATIENTS WITH PSORIASIS ATTENDING A TERTIARY CARE INSTITUTE IN NORTH CHENNAI

Objective: To assess the psycho-social impact of psoriasis and the quality of life (QoL) among psoriasis patients. Methods: This is a cross-sectional study with a sample size of 140 done in a dermatology outpatient clinic in a tertiary care institution in North Chennai. The dermatology life quality index (DLQI) was the primary tool for assessing QoL. Results: The study participants’ mean±SD DLQI score was 8.84±4.59. Out of 140 patients, 32.9% had severely affected QoL with a DLQI score &gt;10. About 81.4% of study participants felt embarrassed due to their skin lesions, and marital life was affected by 36.4%. Suicidal thoughts and alcohol addiction (for coping up) were found to be prevalent among 12.9% of the subjects, both of which were maladaptive coping strategies. It was found that patients with DLQI scores of 10 or more tend to cling to alcohol as a coping mechanism, and this association is statistically significant. Further, a significant association was also noted between the site of the lesion and marital life getting affected by psoriasis. (x2=9.893, p=0.042). Conclusion: Patients with psoriasis are subjected to an intricate web of physical and psycho-emotional challenges. Hence, the physician offering chronic follow-up care to those patients needs to adopt a holistic strategy to address their continuing medical and psychosocial needs.

Characterizing differences inoutpatient dermatologic care utilizationamong disaggregated Asian American subgroups.

Despite having significantly higher rates of atopic dermatitis, psoriasis, and pigmentary disorders compared to White patients, studies suggest that Asian Americans are underrepresented in outpatient dermatology clinics. In this study, we utilize the National Health Interview Survey (NHIS) and prioritize disaggregated analyses to evaluate differences between the most populous Asian American subgroups (Chinese, Filipino, Indian, and "Other") in utilization of outpatient dermatologic care. We utilized multivariable logistic regression to compare outpatient dermatologic care use between each Asian American subgroup and Non-Hispanic Whites. Out of 96,559 adults, our study included 5264 self-identified Asian American and 91,295 non-Hispanic White adults. Most Asian participants were female, had health insurance, and had incomes > 2 times above the federal poverty line. We found that, compared to 21.4% for NH whites, lifetime prevalence of total body skin exam was highest among Filipino Americans (12.3%) and lowest among Indian Americans (7%). Additionally, all Asian American subgroups had a significantly lower odd than NH Whites of ever having a total body skin exam, with Indian Americans having the lowest odds. While thebenefitofTBSEs inIndian Americansis unclear,it is possible that differing cultural perceptions about dermatologic needs,barriers to care,orimmigration status may be contributing tothe observed difference. Furthermore, the Indian diaspora encapsulates a range of skin tones, risk factors, and behaviors that maydifferentiallyinfluencedermatologic disease risk,similar totrends identified among Hispanic patients (Trepanowski et al. in J Am Acad Dermatol 88:1206-1209, 2023). Additional researchutilizingthe sevennational databasesthat have been identifiedasprovidingdisaggregated Asian racial information (Kamal et al. in J Am Acad Dermatol, 2023)maybe useful to furtherilluminate avenues for intervention.

The Relationship between Vitamin D, Body Mass Index and some Dietary Products with Acne Vulgaris; A Case-Control study in Baghdad/Iraq

Objective: To investigate the association of vitamin D level and moderate to severe acne as a primary outcome, and its association with BMI, dairy products, and chocolate consumption. Subjects and Methods: A case-control study was conducted in a dermatology outpatient clinic. Patients, diagnosed with moderate to severe acne vulgaris that warrant treatment with oral antibiotics, and had global acne grading system (GAGS) score of &gt;=19 were eligible to be selected as cases. Aged matched, with no or mild cases of acne were eligible to be selected as controls. The participant height, weight, BMI, and serum circulating 25-hydroxyvitamin D level were measured. A modified food frequency questionnaire was used for dietary history. Results: Comparing Cases (N = 101) and Control (N = 134), the mean of vitamin D level in cases were lower than that in the controls, however no statistically significant difference is observed. There were statistically insignificant differences between the studied groups regarding milk (whole, low fat, skimmed and any type of milk), cheese, yogurt, other dairy products, and chocolate consumption. However, a statistically significant disparity in weight is noted, but not in BMI. Conclusion: The results did not reveal any statistically significant associations between vitamin D level, BMI, dairy and chocolate consumption, and moderate to severe acne. However, it is important to note that this does not definitively rule out the possibility of any potential relationships or effects.

Nutrition's effect on male fertility: A retrospective study

Objective: The aim of this study was to clarify the effect of food on male fertility in a sample of Egyptian men. Background: Eating a varied and healthful diet may be an essential aspect of sustaining good overall health. However, specific vitamins and food groups may have a more substantial impact on reproductive health than others. A male's diet may affect his fertility. Method: Type of study Case control nested in a cross-sectional study It was conducted during the period from September 1st, 2021, to 1st of September 1st, 2022, in Dermatology and Andrology Outpatient Clinic in Menoufia University. Results: The results Twenty hundred and fifty-seven married men who have a regular sexual relation, eating different types of food accepting to participate in this study, the highest percentage of the participants were from urban areas, aged 30-39 years, weighed more than 90 kg, were 170-180 cm tall and had secondary education. Conclusion: Nutrition can both negatively and positively affect the quality of semen. The diet should include vegetables and fruit, fish and seafood, nuts, seeds, whole-grain and fibre-rich products, poultry, and low-fat dairy products.