Journal of Skin and Stem Cell
Volume:8 Issue: 3, Sep 2021

Keloid scars are disfiguring lesions (ie, reddish-brown bulges on the skin surface) formed after a minor injury or surgical invasion. They lead to severe itching or pain, thereby causing physical and psychological distress in patients.

 Scholarly databases, including Web of Science, PubMed, and Google Scholar, were searched for relevant articles using keywords such as “keloids,” “endothelial progenitor cells” (EPCs), and “CD34-positive cells.”

Keloid scars are classified as an intractable disease; their cause is unknown, and there is no specific therapy. Their pathogenic effects on inflammation around wounds and fibroblasts have been extensively studied. However, details regarding their onset mechanism and definitive factors that contribute to their formation have not yet been elucidated. Adult stem cell therapy, especially regenerative therapy aimed at recovering tissue structure and function, has been extensively studied globally. In our recently published study, we identified an association between keloid scar development and EPCs. However, there is still no systematic review in this regard.

This paper provides information on preventing keloids and further understanding the cause of this disease by reviewing previous studies on the association between keloids and EPCs.

India contributes to approximately 60% of the global leprosy burden despite declaring elimination in 2005. Leprosy is associated with typical deformities and disabilities, imposing a huge burden on the society’s mental health and economy. More than three million people in India are estimated to suffer from leprosy-related disabilities with the potential for profound social stigma and discrimination.

This study attempts to document the socio-demographic profile of leprosy patients visiting a public tertiary hospital in Pune to analyze the impact on different domains of the individual’s health and determine the contributory factors thereof.

A cross-sectional, observational study was conducted among 60 patients with leprosy using the WHOQoL-Bref and Dermatology Life Quality Index (DLQI). Medical records of the patients were also scrutinized.

Most patients (40%) were aged between 31 - 40 years with an equal gender distribution, and 63% belonged to MKS Class 4. According to the WHO QoL Bref, 56.66% of the patients had an overall mean score of less than 50, indicating a poor quality of life with the psychological domain being the most-affected, while the DLQI demonstrated that leprosy had a “very large effect” on the quality of life. The determinants that contributed to deteriorated quality of life were female gender, low socioeconomic status, delayed diagnosis and treatment initiation, multibacillary forms, reactional episodes (particularly Type 2), disability grade (visible impairment), and self- perceived stigma.

Leprosy continues to adversely affect the quality of life even a decade after its official elimination. There was good an overall concordance between the WHO QOL-Bref and DLQI questionnaires.

Nail abnormalities comprise a significant proportion of dermatological disorders. Nail is a window that provides vital clues for any underlying, dermatological, and systemic diseases. Any cutaneous assessment is incomplete without examining nails despite which it is a fairly neglected appendage.

This study was carried out to document the clinical pattern, determine the etiology, and identify risk factors for various nail changes.

This cross-sectional observational study was conducted on 200 consecutive patients presenting with nail changes to the outpatient department of dermatology and venereal diseases of a tertiary care hospital. The patients were enrolled after obtaining informed consent. A case record form was designed for every patient, including demographic data, nail characteristics, associated dermatological and systemic disease, and investigation details.

The mean age of the patients was 37.98 ± 16.79 years with a male preponderance. Occupation (housewife and manual laborer) was observed to be a significant risk factor (P < 0.001) for onychomycosis. The chief complaint related to nails was cosmetic in 49.5% of the cases. Etiology-wise nail changes secondary to dermatological diseases (44%) were the most common, followed by infections (36%); however, among dermatological diseases, psoriasis (42.2%) followed by lichen planus (16.6%) predominated. Although nail pitting was noticed in various conditions, there was a significant association between nail pitting and psoriasis (P < 0.001). Onychomycosis showed a significant association (P < 0.001) with nail discoloration and onycholysis. Distal lateral subungual onychomycosis (61.4%) was the most frequently observed pattern; nevertheless, the most common causative agent was dermatophyte Trichophyton rubrum (58.26%). A nail biopsy was performed on 15 cases, with conclusive findings in 12 patients.

Nails should be considered an integral part of the complete dermatological evaluation. The meticulous examination of nails facilitates the early diagnosis of hitherto undetected cutaneous/systemic disease. The nail unit deserves greater attention for better understanding and utilization as a diagnostic tool.

Vulvar intraepithelial neoplasia is a premalignant skin lesion of the vulva that often presents with severe vulvar pruritus, pain, and psychosexual disorders. The technology of non-invasive focused ultrasound surgery has improved over the years. Today its potential to treat these irritating diseases noninvasively is a relatively new area of clinical research interest. Increasing studies in China revealed that FUS treatment is effective and safe. This paper describes the preparation, technique, postoperative care, and results of this focused ultrasound surgery for treating vulvar non-neoplastic epithelial disease. Therefore it could be a future alternative treatment for benign vulvar diseases, replacing many invasive surgical treatments.

Linear IgA dermatosis is a rare autoimmune vesiculobullous disease characterized by homogeneous linear IgA deposits in basement membrane of epidermis, and it can be idiopathic or drug-induced. The pathogenesis of drug-induced linear IgA dermatosis is not fully known yet, but it is associated with specific T cells. The clinical manifestations of the disease include vesiculobullous eruption, erythematous plaques, or string of pearls. Most cases still need additional therapy to avoid the expansion of the disease.

In this study, we present a 17-year-old male patient with erythema plaques, vesicles, and bullae with erosion in facial, oral, neck, trunk, genital, and extremities, pruritus, and burning sensation. The patient was undergoing pulmonary tuberculosis (TB) treatment for one week. Physical examination was done, and total BSA 10% and negative Asboe-Hansen sign were seen. The treatment consisted of delaying administration of TB drugs, desoximetasone cream 0.25%, cetirizine 10 mg, and aspiration of bullae.

Drug-induced linear IgA dermatosis can occur at any age due to the administration of rifampicin and other antibiotics, angiotensin-I converting enzyme (ACE) inhibitors, or nonsteroidal anti-inflammatory drugs (NSAIDs). The drug can stimulate specific T cells that release Th2 cytokines to produce IgA antibodies against the basement membrane of epidermis. Drugs may cause an autoimmune response by cross-reaction with the target epitope, altering the conformation of epitopes, or exposing previously sequestered antigens to the immune system. The causative drug was stopped, and methyl prednisolone 0.5 - 1 mg/kg/day was given as initial therapy. In this study, we reported a rare case of a 17-year-old male with anti-TB drug-induced linear IgA dermatosis. Diagnosis was done based on clinical manifestation, histopathology, and immunofluorescence. The causative drug was stopped, the patient was given topical and systemic steroid therapy and drug desensitization. Remission was noted after six weeks of therapy, and oral steroid was slowly tapered and stopped on day 42. After stopping oral steroids, no lesions were reported. A 6-month follow-up revealed no signs of recurrence.

The reactivated form of the varicella-zoster virus (VZV) is responsible for chickenpox, known as herpes zoster (HZ). Although it is a self-limiting infection, it presents debilitating and painful mucosal and dermal vesicular eruptions. Early identification and management are vital to curbing the spread of HZ infection. In this extensive review, we present an overview of HZ, including its structure, pathophysiology, clinical presentation, complications, investigations, and management. Our review also highlights the prophylaxis and treatment of complications manifested by the VZV.