Hyposalivation in patients with psoriasis: Association with severity, inflammatory, and anti-inflammatory cytokine biomarkers of the disease.

The aim of the study is to expound the effect of psoriasis on salivary glands by evaluating the secretion of saliva and salivary cytokine biomarkers in patients with psoriasis. This study was conducted by recruiting 120 subjects that included 60 patients diagnosed clinically with active psoriasis and 60 healthy controls who were age and gender matched to psoriatic subjects. Unstimulated whole saliva was collected from all the subjects by spitting method, and levels of tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), interleukin-2 (IL-2), and IL-10 (IL-10) were determined via enzyme-linked immunosorbent assay (BT Lab, Shanghai, China). Secretion of saliva in psoriasis patients was considerably reduced than in healthy controls. The concentrations of pro-inflammatory cytokines (TNF-α, IFN-γ, and IL-2) were significantly increased, whereas level of anti-inflammatory cytokine (IL-10) was markedly decreased in the saliva of psoriasis patients with hyposalivation compared to healthy subjects. Our results demonstrated significant negative correlation of salivary flow rates with the disease severity. No significant correlations were obtained between salivary levels of tested cytokines and salivary flow rates in our study. Findings of the study reflect inflammation of salivary glands with reduced salivary flow rates in psoriasis patients. The inflammatory responses in salivary gland tissues by virtue of increased pro-inflammatory cytokines concentrations together with lower anti-inflammatory cytokine levels may have a role in affecting the saliva secretion in psoriasis patients. Secretion of unstimulated saliva in psoriasis patients decreases with the severity and duration of the disease.

Dysbiosis of pro-inflammatory and anti-inflammatory salivary cytokines during psoriasis providing a therapeutic window and a valuable diagnostic aid in future.

The objective of this article is to evaluate the salivary levels of tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), interleukin-2 (IL-2), and IL-10 in patients with active psoriasis and compare them with those in healthy control subjects. This study included 60 subjects who were clinically diagnosed cases with active psoriasis (categorized further into 33 mild to moderate and 27 severe cases based on the Psoriasis Area Severity Index score) and 60 age- and gender-matched healthy control subjects. Levels of TNF-α, IFN-γ, IL-2, and IL-10 in the unstimulated saliva of subjects were determined via enzyme-linked immunosorbent assay (BT Lab). The salivary levels of TNF-α, IFN-γ, and IL-2 were significantly higher, whereas IL-10 concentration was significantly reduced in psoriatic patients in comparison to controls, and the difference increased with the progressing severity of the disease. Assessment of cytokine profiles in psoriasis patients is significant for diagnostic validation and monitoring the disease severity. Saliva offers an alternate, noninvasive, and readily available biological sample for evaluating cytokine levels. Extensive research in this field has been recommended for better scientifically proven conclusions.

A rare manifestation of cysticercosis infestation.

There are many causes of urticaria, which may vary from infections to malignancy. Among the infections, infestations by cysticercosis (larval stage of the tapeworm called Taenia solium) is an important cause. The present report is of forty four years old female who presented with urticaria and swelling on face. The swelling was later diagnosed as cysticercosis by noninvasive ultrasonography. The urticaria subsided after the treatment of cysticercosis. We report this case for rarity of its presentation.

Dermoscopic Assessment of Microneedling Alone versus Microneedling with Platelet-Rich Plasma in Cases of Male Pattern Alopecia: A Split-Head Comparative Study.

INTRODUCTION: Male pattern alopecia (MPA) is a common disorder hugely impacting the quality of life of affected individuals. The meager number of options available for treatment has their own limitations. Novel therapies are continuously being researched for. MATERIALS AND METHODS: The present study included thirty male patients with Hamilton Grade II to Grade V. All patients received four sequential treatments with microneedling (MN) on one half of the scalp and platelet-rich plasma (PRP) with MN (MN + PRP) on the other half for 4 months. Three months following the last session, evaluation was done from the vertex and temporal sites in both the groups by dermoscopic microphotographs by a blinded evaluator. In addition, the patients were asked about their satisfaction score on the basis of treatment outcome. RESULTS: Overall hair thickness showed significant increase in both MN and MN + PRP group. Furthermore, the increase in thickness was almost double in the MN group as compared to MN + PRP group (0.006 and 0.003 mm, respectively). Overall hair density also increased significantly in both the study groups but more in MN + PRP group (14.6 hair/cm2) than the MN group (10.8 hair/cm2). However, the difference between the results of both the groups was not statistically significant. CONCLUSION: To the best of our knowledge, this is the first split scalp study for MPA. We conclude that MN and PRP are both effective in treatment of androgenetic alopecia and improve the hair parameters and patient satisfaction. However, no additional effect of PRP over MN was observed. Both these therapies are safe and well tolerated without any major side effects. Limitations of our study were small sample size and lack of long-term follow-up.

Quality of Life Assessment in Patients with Androgenetic Alopecia.

BACKGROUND: Male-pattern alopecia (MPA) or androgenetic alopecia (AGA) is a commonly encountered dermatological condition present in males and is less common among females. Although AGA is a physiological condition, its impact on person's self-esteem is so great that it cannot be ignored. It has a significant affect over a variety of physiological and social aspects of one's life and even on the individual's overall quality of life (QOL). AIMS AND OBJECTIVES: The aim of this study is to study the clinical profile of 200 male patients having MPA and to access its impact on QOL using the Dermatology Life Quality Index (DLQI) and hair-specific Skindex-29. MATERIALS AND METHODS: Clinical profiles of 200 patients were studied, and QOL assessment was done using the DLQI and hair-specific Skindex-29 scales. RESULTS: Of 200 cases of MPA, majority (41.5%) of the patients belonged to the age group of 21-30 years. Smoking, alcoholism, dietary habits, nature of work, and seasonal variation did not seem to affect the incidence of MPA. Positive family history of MPA was observed in 50% of patients. A mean DLQI score of 13.52 was recorded in the study. The main affected parameter was personal relations with mean score of 2.3. Maximum number of patients had DLQI score between 11 and 20. MPA was observed in 50% of patients. In the study, the mean hair-specific Skindex-29 score was found to be 75.62. The different subscale parameters in Skindex-29 were symptoms, functions, emotions; with respective score of 22.1 ± 5.025, 25.89 ± 4.814, and 27.73 ± 5.942. The major subscales affected were symptoms with a mean score of 3.14. Both hair-specific Skindex-29 and DLQI had a significant correlation, thereby suggesting that AGA significantly affects patient's QOL. CONCLUSION: AGA harmfully affected the patient's QOL which warns the physicians to pay more attention to QOL impairment in patients of AGA for the better understanding of the disease burden on individual patients.

Common Contact Allergens in Patients with Chronic Vesicular Dermatitis of Palms and Soles: A Retrospective Study.

BACKGROUND: Chronic and recurrent vesiculation over the palms and soles is termed chronic vesicular dermatitis. Its etiology is multifactorial and contact allergy plays an important role. AIM: The aim of the study is to evaluate the clinical relevance of patch test reactivity to common contact allergens in chronic palmoplantar vesicular dermatitis. MATERIALS AND METHODS: An observational study was conducted enrolling 152 patients of chronic palmoplantar vesicular dermatitis. Patch testing was carried out with the Indian Standard Battery and also with the materials used by patients. Statistical analysis was carried out using SPSS software. RESULTS: Among 152 patients, 91 were female and 61 male. The peak incidence was in the 14-24 years age group. Their occupations included housewives 48, laborers 26, factory workers 16, farm workers 14, and shopkeepers 12. Patch tests were positive in 79 (52%) patients, including 43 (28.3%) female and 36 (23.7%) male. Patch test reactivity was observed with nickel in 25 (16.4%); potassium dichromate in 21 (13.8%); fragrance mix in 17 (11.2%); p-phenylenediamine in 14 (9.2%); black rubber in 10 (6.6%); mercaptobenzothiazole in 8 (5.3%); and parthenium in 8 (5.3%) patients. Clinical relevance of positive patch tests was determined in 47 (59.5%) patients. CONCLUSIONS: Though patch test reactivity was higher in females as compared with males, the difference was not statistically significant. Clinical relevance of positive patch tests was established with nickel in 9 (19.1%) patients; antigens associated with rubber including black rubber, mercaptobenzothiazole, and thiuram mix in 7 (14.9%); potassium dichromate in 7 (14.9%); p-phenylenediamine in 6 (12.8%); and parthenium in 4 (8.5%) patients.

Living with Acne: Belief and Perception in a Sample of Indian Youths.

BACKGROUND: Acne vulgaris is a common disease among adolescent. There is paucity of information on knowledge and understanding of acne patients about their condition. OBJECTIVE: This study was carried out to evaluate beliefs and perception of acne patient toward their understanding of disease, treatment option, and information source. MATERIALS AND METHODS: A cross-sectional study was conducted on acne patients by means of a questionnaire during 2013-2014 at MMIMSR, Ambala. An adapted version of questionnaire of Brigitte et al. was used and was modified to suit Indian sentiments. RESULTS: A total of 200 acne patients were participated in the study. Mean age of participants was 19.80 years. Male:female ratio was 2:1. Causes implicated were diet (85%), puberty (65%), and mood swings (46%). Fatty food and stress were most common agents held responsible for acne flaring. Popular sources of information were friends and parents. 102 patients had used steroids one way or the other. Acne was considered curable by 65% with an anticipated duration of treatment lasting up to 12 months. CONCLUSION: Misconceptions are widespread among the population. A health education program is needed which should be included in school curriculum to improve their understanding of the condition.