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Author(s): Megha P. Lakum (corresponding author) [1]; Jignaben K. Padhiyar [1]; Nayankumar H. Patel [1]; Jahnvi R. Patel [1] A two-year-old girl, born at full term by vaginal delivery to [...]

The article discusses a rare case of late infantile form of Multiple Sulfatase Deficiency (MSD) in a two-year-old girl. The child presented with dry skin lesions and neurological symptoms, leading to a diagnosis of MSD through genetic analysis. MSD is a lysosomal storage disorder caused by mutations in the SUMF1 gene, resulting in neurologic deterioration, skeletal anomalies, organomegaly, and ichthyosis. The article emphasizes the importance of considering MSD in children with skin problems and neurological issues, highlighting the need for detailed examinations and genetic analysis for accurate diagnosis and counseling. [Extracted from the article]

Anti-melanoma differentiation-associated gene-5 antibody (anti-MDA-5 Ab) associated with clinically amyopathic dermatomyositis (CADM) is characterized by vasculopathic ulcers, mechanic's hands, and progressive interstitial lung disease (ILD). We present a case of 38-year-old female who presented with all these classical clinical features. Her investigations revealed normal serum muscle enzyme levels and the presence of anti-Mi2 and anti-MDA-5 antibodies by immunoblot. Imaging study revealed changes suggestive of ILD. She was treated with rituximab along with oral glucocorticoid and other supportive treatment to which she didn't respond adequately. Recently, it has been postulated that plasmacytoid dendritic cells produce interferon which is responsible for tissue injury in dermatomyositis (DM). Tofacitinib, by inhibiting JAK-STAT pathway, inhibits downstream cytokines, mainly type 1 interferon. So, we added tofacitinib as adjuvant therapy in our patient. Post-six months of commencement of adjuvant tofacitinib, patient experienced remarkable improvement in cutaneous features as well as in pulmonary fibrosis. [ABSTRACT FROM AUTHOR]

Itraconazole (ITZ) has been the mainstay of oral antifungal treatment for the current epidemic of recalcitrant dermatophytosis (RD) in India. Recently, a newer formulation of ITZ, super bioavailable itraconazole (SUBA-ITZ), is made available in the market by many pharmaceutical companies. It is important for dermatologists to understand the pharmacokinetic properties of SUBA-ITZ vis-a-vis conventional pellet formulation to use it effectively and safely. Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) has established a special interest group for recalcitrant dermatophytosis (SIG-RD) to strengthen research, continuing medical education, and industry collaboration on the subject. This position statement on SUBA-ITZ by SIG-RD is an attempt to address current pieces of evidence and the position of this new formulation in the management of RD. [ABSTRACT FROM AUTHOR]

Background: The present epidemic of dermatophytosis in India is marked by an increase in chronic, recurrent and disseminated cases. A combination of oral itraconazole and topical luliconazole is being increasingly utilised by dermatologists in India. The superiority of this combination is not supported by robust clinical trial data. Objective: We conducted this randomised, open-label, two arms, parallel assignment intervention trial between November 2022 and May 2023 to determine the superiority of topical 1% Luliconazole over bland emollient as adjuvant to systemic Itraconazole therapy in the management of dermatophytosis. Method: In this study, 135 patients of either sex were randomised to two study cohorts. Major exclusions being concomitant medical illness, use of concomitant medication and substance abuse. Participants were randomly assigned to receive topical bland emollient, (Cohort I, n = 67) or topical luliconazole, (Cohort II, n = 68). Both cohorts received oral itraconazole 200 mg/day (100 mg BID) and levocetirizine 5 mg twice a day as a systemic regime. Clinical and mycological cure at the end of 6 weeks and clinical relapse among cure patients during 10-week follow-up were observed. Results: The cure rates for Cohorts I and II at 6 weeks were 50 (74.62%) and 56 (82.35%), (p = .46), respectively. During the 4-week follow-up period, clinical relapses were observed in 16 (32%) of the 50 patients in Cohort I and 12 (21.43%) of the 56 patients in Cohort II (p = .18). Luliconazole cohort shows a significantly higher medical cost (p < .05). Conclusion: Our study shows a similar cure rate and relapse rate for patients receiving topical Luliconazole versus topical bland emollient as an adjuvant to the systemic itraconazole regime. [ABSTRACT FROM AUTHOR]

Byline: Nayankumar. Patel, Jignaben. Padhiyar, Tejas. Patel, Nishi. Trivedi, Vidhi. Chandibhamar, Ranjan. Raval Sir, Linear IgA bullous dermatosis (LABD) is a rare autoimmune bullous disease also known as linear IgA [...]

Byline: Jigna. Padhiyar, Nayankumar. Patel, Trusha. Gajjar, Bhagirath. Patel, Aseem. Chhibber, Mansi. Buch Sir, We highly appreciated authors for their interest in the article 'A distinct clinicopathological presentation of cutaneous [...]

Byline: Jignaben. Padhiyar, Nayankumar. Patel, Trusha. Gajjar, Bhagirath. Patel, Aseem. Chhibber, Mansi. Buch Infectious diseases can clinically present as vesiculobullous disorders. Direct immunofluorescence (DIF) study of skin biopsy helps distinguish [...]

Well‑designed and rigorously conducted randomized controlled trial (RCT) can produce most valid and precise scientific evidence. Any intervention, be it systemic or topical medicine, dermatology procedure needs to be tested for its efficacy in improving particular disease condition and RCT should come into mind of investigator. The biggest strength of RCT lies in two self‑explanatory factors; they are randomized and controlled. Randomization of study subjects eliminates selection and confounding bias and controlling of study condition improves the internal and external validity of findings. “Blinding” eliminates assessment bias. If one starts a comparative study without stating proper hypothesis, he/she would end up collecting lots of data which does not make sense. PICOT format helps in formulating research question. Writing a detailed protocol based on hypothesis describing in detail methodology, sample size calculation, randomization method, and blinding procedure up to statistical analysis plan is very important step in planning of RCT. Trials registered prospectively contribute to transparency of the trial and are considered to reduce the publication bias by reducing selective publication of positive outcomes. Adverse events can occur at any time during conduct of an RCT and should be reported and kept track of. Physical injury resulting from clinical trial participation is entitled to financial compensation. During preparation of final manuscript of study, the CONSORT guidelines must be followed to improve the quality of reporting of RCTs. Clinical trials provide evidence‑based approach in medicine and a designed and well‑implemented trial can alter clinical dermatology practice for a healthier tomorrow. [ABSTRACT FROM AUTHOR]

Medical imaging greatly affects medication, particularly in the fields of diagnosis analysis and careful surgical planning. In any case, medical imaging gadgets continue delivering a great deal of data information for each patient. Medical image examination and data compression is a significant region of research which targets delivering calculations that diminish record size and simultaneously keep up important symptomatic data. Medical image compression applications are quality-driven applications which request high caliber for specific areas that have demonstrative significance for diagnosis, where even little quality decrease presented by lossy coding may modify resulting finding, which may cause serious lawful outcomes. The fundamental focal point of this paper is to investigate procedures and discover a compression algorithm that can eliminate irrelevant medical data and reconstruct medical image rapidly while keeping up a decent degree of visual quality for certain regions of medication where it is adequate to keep up high image quality just for indicatively noteworthy regions, for instance, tumor segment of the cerebrum MRI. Wavelet multiresolution decomposition of images has indicated its proficiency in many image processing areas and explicitly in compression. Because of this, The Discrete Wavelet Transform (DWT) is used to code Region of Interest and Discrete Cosine Transformation (DCT) is utilized to code background region. A couple of examinations were led to break down the calculations dependent on compression proportion, decompressed image quality and execution speed. [ABSTRACT FROM AUTHOR]

Introduction: In the present epidemic of chronic, recalcitrant, and widespread dermatophytosis, impact of disease on quality of life (QoL) can be severe. Similarly, financial impact due to treatment cost and loss of wages needs consideration too. Aims and Objectives: Our primary aim was to evaluate the impact of dermatophytosis on QoL and the financial burden on individual and family. Materials and Methods: Adult patients having dermatophytosis were included in the study. Standard Dermatology Life Quality Index (DLQI) questionnaire was used to evaluate the psychosocial impact, and financial burden was evaluated by nine binary questions. Results: A total of completed 299 DLQI surveys and 275 financial burden surveys were taken for final analysis. Mean DLQI was 12.25 (SD = 5.56, n = 299). Significant association between total body surface area (BSA) and DLQI score was observed (rs= 0.251,P <0.001, n = 299). Presence of tinea corporis was found to be significantly affecting the choice of clothing (P = 0.018, χ2 = 5.127, CI 95%). More numbers of male respondents reported loss of work or study hours due to their illness (P = 0.015, χ2 = 5.196, CI 95%), which was significantly associated with the BSA involved (P < 0.05, t = 5.529, CI 95%). Some difficulties in sexual activity were reported by 35.6% patients, which has significant association with tinea cruris (P = 0.001, χ2 = 10.810, CI 95%). Median household income was 10,000 INR and interquartile range (IQR) being 8,000–19,000. Mean financial burden calculated at 3.458 (SD = 1.696, n = 275), whereas mean financial worry reported by patient stood at 3.661 (SD = 1.216, n = 275). Financial burden showed significant correlation with "previous treatment approximate cost," financial worry, and DLQI (P < 0.05, CI 95%). Financial worry (P = 0.016, rs= 0.145, CI 95%) and financial burden (P = 0.002, rs- = 0.145, CI 95%) both showed positive correlation with duration of disease. Conclusion: In present scenario of Dermatophytosis in India, the disease and its treatment causing impact on QOL as well as on personal financial burden and worry need consideration. [ABSTRACT FROM AUTHOR]

Secondary cutaneous diffuse large B-cell lymphoma has a higher international prognostic index score and worse prognosis than diffuse large B-cell lymphoma, leg type. Secondary cutaneous DLBCL demonstrates higher international prognostic index (IPI) when compared to DLBCL leg type.[[5]] According to revised IPI score, our patient had poor prognosis with probable overall survival of 55% and progression-free survival of 53%. Secondary cutaneous lymphoma: Comparative clinical features and survival outcome analysis of 106 cases according to lymphoma cell lineage. [Extracted from the article]

Itraconazole (ITZ) has been the mainstay of oral antifungal treatment for the current epidemic of recalcitrant dermatophytosis (RD) in India. Recently, a newer formulation of ITZ, super bioavailable itraconazole (SUBA-ITZ), is made available in the market by many pharmaceutical companies. It is important for dermatologists to understand the pharmacokinetic properties of SUBA-ITZ vis-a-vis conventional pellet formulation to use it effectively and safely. Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) has established a special interest group for recalcitrant dermatophytosis (SIG-RD) to strengthen research, continuing medical education, and industry collaboration on the subject. This position statement on SUBA-ITZ by SIG-RD is an attempt to address current pieces of evidence and the position of this new formulation in the management of RD., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Dermatology Online Journal.)