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Industrial Psychiatry Journal 2024Vitiligo is a common depigmenting dermatosis characterized by milky-white macules or patches. Any pathological discoloration of the skin has been linked to an impact on...
BACKGROUND
Vitiligo is a common depigmenting dermatosis characterized by milky-white macules or patches. Any pathological discoloration of the skin has been linked to an impact on the body image of an individual, and vitiligo has been linked to decreased self-esteem and poor socialization of the affected people. In Indian society, vitiligo is labeled as Shweta-Kushta (i.e., white-colored leprosy) and is compared to leprosy-a more stigmatizing skin condition.
AIM
This study aims to study gender-related differences in the quality of life of Indian vitiligo patients.
METHODOLOGY
In this hospital-based cross-sectional study, a total of 55 vitiligo patients (females 25 and males 30) were enrolled using the purposive sampling technique. The sample was assessed on Dermatology Life Quality Index (DLQI) questionnaire, Rosenberg Self-Esteem Scale (RSS), and General Health Questionnaire-12 (GHQ-12) to assess their quality of life, self-esteem, and psychological well-being, respectively. The gender differences in sociodemographic and clinical details as well as their relationship with the quality of life of the patients were sought with the help of appropriate statistical measures.
RESULTS
The patients of both genders were comparable in terms of all sociodemographic and clinical variables except the females being less educated and employed than the males. There was a statistically significant trend of higher mean DLQI total score in females than males (6.6 ± 3.55 vs 4.8 ± 2.71, Mann-Whitney U = 263.5, =0.058). Significantly, the average DLQI score in female vitiligo patients was negatively related to family income ( = -.659, <.001) and it was significantly higher for the patients from a rural background than those from an urban background (8.55 ± 3.30 vs 5.07 ± 3.03, Mann-Whitney U = 33.5, <.05). The average DLQI score was negatively correlated to RSS score but positively correlated to GHQ-12 score in patients of both genders.
CONCLUSION
The quality of life of female patients with vitiligo is poorer than the same in male patients. The poor financial condition of families and rural living are two factors related to the poorer quality of life of female patients. A poorer quality of life in vitiligo patients of both genders is linked with decreased self-esteem and decreased psychological well-being. Gender-related issues in the quality of life and the overall well-being of such patients are important in their management and policy-making.
PubMed: 38853817
DOI: 10.4103/ipj.ipj_74_23 -
Combined low-dose isotretinoin and long-pulsed nd: YAG laser in the treatment of post-acne erythema.Archives of Dermatological Research Jun 2024Post-acne erythema (PAE) is a bothering skin condition that emerges from inflammatory acne and persists after its resolution. It is characterized by telangiectasia and...
Post-acne erythema (PAE) is a bothering skin condition that emerges from inflammatory acne and persists after its resolution. It is characterized by telangiectasia and erythematous macules. the role of 1064-nm Nd: YAG when combined with low-dose isotretinoin in the acne erythema treatment. forty-eight PAE patients were involved in the study. They were divided into two groups; group (A) patients administering a low dose of oral isotretinoin (10 mg/day) and underwent a total of six two-week interval sessions of 1064 ND-YAG laser treatment, group (B) patients administering a low dose of oral isotretinoin (10 mg/day) only. All adverse effects experienced during the course of therapy were documented, and photos were taken before the start of the treatment and following the end of the treatment duration. Following the completion of the therapeutic intervention, a significant improvement in clinical condition was observed in both groups, with more improvement in group (A) compared to group (B) as evidenced by a notable improvement in the score on the Clinician Erythema Assessment Scale (CEAS) and also a significant decrease in the mean value of optical density of the erythema. combined 1064-nm Nd: YAG with low-dose isotretinoin may be an efficient and secure line in the PAE treatment. Also, the combined therapy had superior results when compared to low-dose isotretinoin alone.
Topics: Humans; Isotretinoin; Erythema; Acne Vulgaris; Female; Male; Lasers, Solid-State; Adult; Dermatologic Agents; Young Adult; Treatment Outcome; Adolescent; Combined Modality Therapy
PubMed: 38850412
DOI: 10.1007/s00403-024-03143-5 -
Indian Dermatology Online Journal 2024Vitiligo is an inveterate disease of great aesthetic concern presenting with depigmented macules and patches. It is often incorrigible to medical treatment.
BACKGROUND
Vitiligo is an inveterate disease of great aesthetic concern presenting with depigmented macules and patches. It is often incorrigible to medical treatment.
AIM
To study the clinical profile of vitiligo patients and evaluate the effect of 5% 5-fluorouracil (5-FU) cream with microneedling.
MATERIALS AND METHODS
This observational analytical study was conducted from November 2019 to July 2021. A total of 33 adult vitiligo patients were treated with oral mini-pulse (dexamethasone) therapy and topical corticosteroid (clobetasol propionate 0.05%). Patient's total number of vitiligo lesions with <10-cm size were counted and half of the lesions were treated with 5-FU + microneedling (Group A), while a remaining number of lesions were not treated with 5-FU + microneedling (Group B). In the case of the odd number of lesions, the total number of lesions minus one was considered and then divided into equal numbers for treatment. The procedure was performed every 2 weeks for 3 months. Clinical improvement was assessed monthly till 6 months by serial clinical photographs and grading scores.
RESULTS
Initiation of repigmentation started in the first month in Group A, whereas in Group B, it was seen in the second, which was statistically significant ( < 0.0001). Excellent improvement (>75% repigmentation) was noted in Group A as compared to Group B at the end of 6 months ( < 0.0001).
CONCLUSIONS
Needling with 5% 5-FU appears to be a simple, safe, and effective treatment in vitiligo. It can be used in poor responders to conventional therapy.
PubMed: 38845671
DOI: 10.4103/idoj.idoj_774_23 -
Indian Journal of Dermatology,... Apr 2024Telangiectasia macularis multiplex acquisita is a rarely described entity, characterized by multiple asymptomatic erythematous and/or brownish macules with...
Telangiectasia macularis multiplex acquisita is a rarely described entity, characterized by multiple asymptomatic erythematous and/or brownish macules with telangiectasias, preferably on bilateral upper arms and trunk. We reported a 56-year-old Chinese man with telangiectasia macularis multiplex acquisita. Dermoscopic examination demonstrated an erythematous-brownish background with a striking angioid streak pattern (a central arteriole with superficial radiating small vessels attributed to spider-like eruptions) and linear-irregular branching vessels. We suggest dermoscopic features can be used to improve the accuracy of clinical diagnosis and avoid unnecessary skin biopsies.
PubMed: 38841960
DOI: 10.25259/IJDVL_762_2023 -
Clinical, Cosmetic and Investigational... 2024Porokeratosis (PK), characterized by keratotic lesions with an atrophic center and a prominent peripheral ridge, with a typical histological hallmark, namely, the...
Porokeratosis (PK), characterized by keratotic lesions with an atrophic center and a prominent peripheral ridge, with a typical histological hallmark, namely, the cornoid lamella, has two forms: disseminated and localized. While PK often converts into squamous cell carcinoma (SCC), conversion from disseminated superficial porokeratosis (DSP) alone is rarely reported except for one case in which DSP and LP coexisted and converted to SCC. Here, we report the case of a patient with SCC converted from DSP alone, presenting with coin-sized macules on the bottom right of his waist that developed into an ulcer at the center. The patient underwent radiation therapy, which effectively treated the SCC but did not resolve the PK. This article highlights regular follow-up and undergo comprehensive diagnosis, both of which are beneficial to enable early detection and management of DSP that has converted to into SCC; in addition, standardized medical treatment may help improve the treatment therapeutic effect of in similar diseases.
PubMed: 38827628
DOI: 10.2147/CCID.S463569 -
Cureus Apr 2024A relatively rare inherited condition known as Peutz-Jeghers syndrome (PJS) causes mucocutaneous pigmentation and gastrointestinal hamartomatous polyps. These polyps are... (Review)
Review
A relatively rare inherited condition known as Peutz-Jeghers syndrome (PJS) causes mucocutaneous pigmentation and gastrointestinal hamartomatous polyps. These polyps are non-cancerous, but the presence of PJS significantly increases the chances of developing various types of cancers, such as colorectal, pancreatic, gastric, and breast cancer. The purpose of this review article is to give an abbreviated summary of what is currently known about this syndrome, covering its clinical symptoms, pathophysiology, genetics, and management. PJS also raises the risk of getting many malignancies, especially gastrointestinal and pelvic cancers. Symptoms of the gastrointestinal tract brought on by hamartomatous polyps are frequent and include stool blockage, bleeding, and stomach pain. The pigmentation commonly appears as prominent bluish-black macules and frequently affects the skin and mucous membranes. Small macules and large regions of lentiginous pigmentation are both possible. Numerous areas, including the perioral area, buccal mucosa, fingers, and lips, exhibit pigmentation. Bowel obstruction and intussusception risk can be decreased by early identification and routine surveillance of gastrointestinal polyps. The gene serine/threonine kinase 11 (STK11) controls several biological functions, including cell polarity, growth, and proliferation. Genetic counseling is recommended for the affected individuals and their families. This can help assess the risk of passing on the condition to future generations and provide information about available reproductive options. Regular surveillance is crucial for managing the syndrome and reducing the risk of cancer development. Other syndromes and extra-gastrointestinal characteristics, such as somatic tumor polyps outside the gastrointestinal tract, are also linked to this syndrome.
PubMed: 38800180
DOI: 10.7759/cureus.58887 -
Problemy Endokrinologii Sep 2023We presented the clinical case of neurofibromatosis type 1 (NF-1) associated with pheochromocytoma (PHEO) in a man under 40 years old without family history. The... (Review)
Review
We presented the clinical case of neurofibromatosis type 1 (NF-1) associated with pheochromocytoma (PHEO) in a man under 40 years old without family history. The diagnosis of NF-1 was established based on 4 signs of the disease (multiple café au lait macules, scoliotic changes in posture, the presence of multiple neurofibromas, Lisch nodules). The diagnosis of PHEO was determined by a significant increase of free metanephrin/normethanephrin levels in daily urine, a malignant CT phenotype of the right adrenal tumor, and confirmed by pathomorphological study. Genetic tests revealed a new mutation in one of the alleles of NF1 gene, a deletion of a 566 bp gene fragment, including exon 19 with a size of 73 bp. This mutation leads to splicing of exons 18 and 20, frameshift, and termination of protein synthesis. A study of the level of transcription of the genes associated with PHEO (RET, TMEM127, MAX, FGFR, MET, MERTK, BRAF, NGFR, Pi3, AKT, MTOR, KRAS, MAPK) was conducted, a statistically significant decrease in the level of transcription of the KRAS and BRAF genes and increase in the level of transcription of the TMEM127 gene in comparison with control samples have been detected. This case demonstrates the need for timely recognition of NF-1 for further appropriate patient's follow up and show the effectiveness of a multidisciplinary approach to the diagnosis and treatment of NF-1-associated catecholamine-secreting tumors.
Topics: Humans; Pheochromocytoma; Neurofibromatosis 1; Male; Adrenal Gland Neoplasms; Adult; Neurofibromin 1; Mutation
PubMed: 38796761
DOI: 10.14341/probl13345 -
Postepy Dermatologii I Alergologii Apr 2024Vitiligo is an acquired disorder characterized by the progressive loss of functional melanocytes, resulting in depigmented macules and patches on the skin. It affects a...
INTRODUCTION
Vitiligo is an acquired disorder characterized by the progressive loss of functional melanocytes, resulting in depigmented macules and patches on the skin. It affects a significant portion of the world's population, with no specific gender or geographic predilection.
AIM
To explore the current understanding of the association between vitiligo and COVID-19.
MATERIAL AND METHODS
This is a cross-sectional comparative research of 90 vitiligo patients, separated into two groups: those with COVID-19 confirmed by PCR and those without, gathered in 2018 before the pandemic. Al-Sadar teaching hospital in Al Basra gathered data from March 2021 to May 2022. Vitiligo patients with other infections were excluded. Wood's test was used to confirm vitiligo (VASI score). Age, gender, site of vitiligo, number of lesions, and family history were gathered for all patients in both groups.
RESULTS
Patients with vitiligo and COVID-19 had mild (70.27%), moderate (18.92%), and severe (10.81%) infections. Significant differences were found in age, duration, and VASI score, with younger patients and lower VASI scores in the Vitiligo + COVID-19 group. Females (60.6%) were more affected, and lower limbs (66.7%) were the most common site of vitiligo lesions in COVID-19 patients.
CONCLUSIONS
70.27% of vitiligo and COVID-19 patients had mild infections, 18.92% had moderate infections, and 10.81% had severe infections. Patients with both disorders were younger, had shorter vitiligo durations, and lower VASI scores than those with just one. Females were more likely to have both disorders, and lower limb vitiligo was more prevalent. Family history did not affect either group.
PubMed: 38784935
DOI: 10.5114/ada.2024.138670 -
Cureus Apr 2024Cutaneous collagenous vasculopathy (CCV) is a rare idiopathic dermal microangiopathy. Clinically, it presents as diffuse cutaneous telangiectasias that are...
Cutaneous collagenous vasculopathy (CCV) is a rare idiopathic dermal microangiopathy. Clinically, it presents as diffuse cutaneous telangiectasias that are indistinguishable from other benign vascular entities, thereby posing a diagnostic challenge. We present a case of CCV successfully treated with pulsed dye laser (PDL). A 27-year-old male presented with generalized erythematous macules, diagnosed as CCV via histopathology. After a successful test spot, PDL treatment resulted in significant improvement. The pathogenesis of CCV involves altered dermal microvasculature and veil cell activation. Epidemiologically, it primarily affects Caucasians, most often in the middle-aged adult population. A negative family history of similar lesions can help narrow down the differential diagnosis. Diagnosis requires biopsy, with histopathological examination demonstrating vessel ectasia and collagenous vessel wall thickening. Given its rarity, CCV presents diagnostic and management challenges though PDL emerges as a promising treatment modality for this condition.
PubMed: 38765411
DOI: 10.7759/cureus.58391