Knowledge, Attitude & Practice Among Psoriasis Patients in India Towards Teledermatology During COVID-19 Pandemic

Background: The current COVID-19 pandemic has imposed upon the entire community norms of social distancing and home quarantine. Follow up consultations in these times can be made through teledermatology through smart phones. Success of this technology in these hours of crisis depends upon the knowledge, attitude and behaviour of patients towards teledermatology. Follow up consultations done through teleconsultations will decrease risk of exposure to COVID-19 among psoriasis patients who need frequent follow ups. Aim: The main objective of this study is to assess the awareness, knowledge, attitude and practice of teledermatology through teledermatology among psoriasis patients at a tertiary care teaching hospital. Materials and Methods: A cross-sectional survey, from Psoriasis Clinic registry maintained in the outpatient department of DVL of a tertiary care teaching hospital in India is conducted. A pre-validated self-administered questionnaire is used for the survey to assess knowledge, attitude and practice of teledermatology. Analysis will be done as per study objectives using descriptive statistics for quantitative data and content analysis for qualitative data. Results: Out of 150 patients, 87(58%) were males and females were 63(42%). Most common age group to participate in the study was 36-45 years- 43(28.7%). Majority of participants were educated up to –graduate 53(35.3%). Males had higher knowledge and attitude scores compared to females. Most of the patients found using teleconsutations easy and convenient. Conclusion: Teledermatology is the need of the hour to be implemented in these hours of COVID-19 pandemic.

Syringocystadenoma Papilliferum at an Unusual Location: a Case Report

A case of 15year old female presented with lesion over back since childhood, with occasional bleeding and oozing from lesion without any associated systemic complaints. There were multiple verrucous coalescing papules forming plaque with overlying erosion present over left lower back- diagnosed provisionally as angiokeratoma circumscriptum and was biopsied. Histopathology revealed findings consistent with Syringocystadenoma papilliferum. Surgical excision was done and closed with rotation flap. Syringocystadenoma is benign cutaneous adnexal tumor presenting clinically with many morphologies such as warty papules, nodules, plaques with oozing of serous material. Lesion is usually seen in head and neck area in most cases however can also occur on extremities, buttocks, anogenital region. It is characterized by multiple invaginations from skin surface in association with hair follicles lined by cuboidal to columnar epithelium on luminal aspect and myoepithelial cells on outside. There is papillary architecture and dermal ductal component.

The Psychosocial Impact of Rosacea in Men: First Quantitative Study

Psychosocial impact of Rosacea in men has generally been a topic that in understudied in literature. We conducted a cross-sectional paper-based survey was conducted with male patients who have experienced rosacea for at least five years at the dermatology outpatient department at New Cross Hospital in Wolverhampton, England to determine the psychosocial impact of Rosacea on Men Quality of life and self-esteem. 52 % of the male population were noted to be “often” mentally pre-occupied by rosacea and frustrated due to rosacea. 85 % of the male population “never” used cosmetic camouflage. Mean function score is noted to be 6.81. This indicates that men are less in favour of coping mechanisms. Results from this study highlight that despite the emotional impact rosacea has on the male population, they do not frequently use coping mechanisms. This emphasises the psychosocial impact of rosacea on male population and the need for dermatologists to address the emotional impact on men as part of management as well as to raise awareness around this topic.

The challenge of Diagnosing Common Dermatomycosis by Reflectance Confocal Microscopy

Background: Traditional detection of fungal infections of the skin relies on microscopy techniques or fungal culture. Currently, reflectance confocal microscopy (RCM) has been widely applied to assist the diagnosis of commondermatomycosis with advantages of non-invasiveness, celerity, real time, and repeatability. Materials and Methods: A total of 478 clinically suspected dermatomycosis patients were enrolled in this study including 148 cases of tinea manus and pedis, 188 cases of tinea corporis and cruris and 142 cases of pityriasis versicolor. RCM examination was performed to image the lesions. Aim: This study aimed to summarize the image characteristics of in vivo RCM examination on common dermatomycosis and retrospectively evaluate its accuracy as compared with microscopy results. Furthermore, we attempted to tackle the challenges of RCM diagnosis on common dermatomycosis. Results: Based on RCM images, 231 of 478 (48.3%) patients were detected with hyphae. Among all RCM confirmed cases, 58 out of 148 (39.2%) were tinea manus and pedis, 145 out of 188 (77.1%) were tinea corporis and cruris, and 28 out of 142 (19.7%) were pityriasis versicolor. The remaining patients (51.7%) could not be diagnosed by the dermatologist according to RCM. Hyphae structures were primarily identified during diagnoses of dermatomycosis by RCM. Conclusions: RCM is a novel optical imaging technique that confers high-resolution images of fungi. RCM has certain advantages in the diagnosis of tinea manus and pedis. RCM is not suitable for the diagnosis of pityriasis versicolor.

Use of Lipocavitation in the Treatment of Localized Adiposity: a Review

With the growing demand for body, contouring, non-invasive devices for reducing localized fat have become increasingly popular and have grown exponentially in the last decade. The Lipocavitation technique has been used recently for this purpose and has been evaluated as a method for the selective destruction of adipose tissue. This work has as main objective, to bring up the practice, the mechanism of action in the body and the effects of the use of lipocavitation in the treatment of localized adiposity. This is an exploratory study of bibliographic review, with consultation in the databases of the VHL (Virtual Health Library), PUBMED and MEDLINE and SciELO. The results showed that the lipocavitation technique used in aesthetics to reduce adipocytes allows the destruction of localized fat, facilitating its elimination and contributing to the reduction of localized measures. With the current technological advances, a variety of techniques can be used, or even combined, allowing innovation to professionals, bringing improvement and well-being to each individual.

The Neuronal Theory in the Pathogenesis of Vitiligo: Past and Present

Vitiligo is a common skin disorder with an estimated prevalence of 1-2% of the world population. It is characterised by well demarcated milky white patches of depigmentation which have the tendency to enlarge and spread peripherally. The pathogenesis is not fully understood, a process leads and end in the loss of functional melanocytes from the epidermis. There are many proposed theories and hypotheses, none of which can fully explain its pathogenesis. However, lately it is believed that an overlap between some of these theories can present better understanding. This is to include the two long standing theories i.e., the autoimmune and the neuronal. The latter been proposed in 1959, initially based on clinical observations and studies, including animal, physiological, biochemical, embryonic, structural and electron microscopy. In 1994 new evidence emerged linking the neuronal theory to autoimmune mechanisms by demonstration of changes in Neuropeptides in particular Neuropeptide Y (NPY), in the skin at the active edge of vitiligo skin. This review paper highlights all evidence supportive of the neuronal theory in the pathogenesis of vitiligo past and present.

Flushing Associated with Prolonged Mask Wearing During Covid-19 Pandemic Among the General Population

Wearing mask was encouraged to prevent dispersal of droplets and to reduce the risks of environmental contamination by COVID-19 during COVID-19 pandemic. However, we noticed a rise in the initial attack, relapse or exacerbation of flushing among general population due to long-time mask wearing. In this manuscript, we reported the characters of the mask-related flushing, and attempted to explain the reasons and put forward some precautions for that. We suggested that general public should be aware of proper and rational mask wearing to avoid inducing and aggravating flushing. We hope that our findings will contribute to increase the awareness about mask related flushing.

Chitin and Lignin: Old Polymers and New Bio-Tissue- Carriers

Worldwide consumers are nowadays much more focusing on their wealth and appearance, having increased their worry caused from the pollution, plastic wastes and the earth' disasters further increased for the COVID-19 pandemic. This trend has created an heightened demand for products which, formulated with natural and functional ingredients and carried by sustainable delivery systems, should be produced and packed with biodegradable compounds. The paper suggests to formulate innovative cosmetic and medical products based on the use of carriers made by biodegradable polysaccharide-tissues embedded by micro-nano particles of chitin nano fibril-nano lignin complexes, encapsulating different active ingredients. Thus, data on chitin, lignin and their complexes are reported and discussed, focusing the attention on their possible use to make innovative products, characterized for their effectiveness, safeness, and biodegradability.

The Arabic Version of MELASQoL Scale: Translation, Cultural Adaptation, with Assessment of Reliability and Validity

Background: Melasma has significant emotional and psychological effects and significant negative impact on patients’ quality of life (QoL). Melasma QoL Scale (MELASQoL) is a specific questionnaire that has been developed to assess the effect of melasma on patient’s QoL. Objective: Translation, cultural adaptation, reliability and validation of melasma specific QoL sale (MELASQoL) into Arabic. Patients and Methods: A total of 65 adult Egyptian female patients with melasma aged ≥18 years old with skin phototypes type III-V were enrolled in this study. Wood’s light was used for determination of the type of melasma either epidermal, dermal or mixed. Melasma severity was assessed by using the melasma area and severity index (MASI) score and the new modified score (mMASI). The impact of melasma on QoL was evaluated using the Arabic version of MELASQoL scale after translation and cultural adaptation according to the WHO guidelines. The questionnaire’s reliability and validity was assessed. Results: The internal consistency for the 10-item of the MELASQoL-A scale was excellent; Intra-class Correlation Coefficient (ICC) = 0.914 and Cronbach’s alpha coefficient (Cronbach α = 0.944) indicating high reliability of the developed Arabic version. There was significant positive correlation between the MELASQoL-A scale and the MASI score (r= 0.41; p= 0.0027), and the mMASI score (r = 0.36; p= 0.0032). Conclusion: The Arabic version of the MELASQoL scale was found to be a reliable and valid measure for evaluating the QoL among Egyptian melasma patients, supporting its use in Arab communities.

Paradoxical Psoriasis During IL-17 Blockage: Two Memorable Patients

47 year-old man who suffered for plaque psoriasis since 2013 was previously treated with topicals, UVB photherapy, acitretin, methotrexate and adalimumab (Imraldi®) with scarce response. Brodalumab (IL-17 receptor chain A blocking antibody) at 210 mg sc day 0, week-1, week-2 and every 2 weeks was initiated (baseline PASI of 16) with fast improvement of psoriasis (PASI-90 at week 4) and new onset of erythema, pustules and pain in the palmoplantar area after each subcutaneous Brodalumab administration and progressive improvement after 5-8 days.