Open Access Case Study

Retronychia: A Common and Misdiagnosed Condition

Carla Barbini, Y. Rashid Benitez, Agustina Lambertini, Lourdes M. Pérez-Chada, Corina I. Busso

Asian Journal of Research in Dermatological Science, Page 19-24

We report the case of two patients who consulted because of yellowing and thickening of their toe nails, with several relapses throughout time. Hand nails were unaffected. Both patients presented negative potassium hydroxide test and fungus culture, which excluded a diagnosis of onychomycosis. Further examination showed signs of trauma and growth of several overlapping nail plates, which lead to the diagnosis of retronychia, a common but misdiagnosed condition. We aim to emphasise the clinical aspects and possible treatments available for these types of cases.

Open Access Original Research Article

Efficacy and Safety of Adalimumab 40 mg Weekly Dosingin Patients with Resistant Psoriasis

Meltem Turkmen, Sinan Dogan

Asian Journal of Research in Dermatological Science, Page 1-5

Background: The recently updated dosing recommendation for adalimumab for psoriasis states that patients with inadequate response to adalimumab every other week (EOW) after 16 weeks may benefit from an increase in dosing frequency to 40 mg every week (EW).

Objectives: This study aims to investigatethe efficacy and safety experience of dose escalation of adalimumab to 40 mg weekly dosing patients with psoriasis with suboptimal response to 40 mg EOW dosing.

Methods: In this report 22 moderate-to-severe psoriasis patients treated with 40 mg adalimumab EW were evaluated retrospectively. Primary endpoints were safety and efficacy of treatment defined as statistically significant improvement of PASI and PGA in the 24 week of therapy.

Results: A total of 22 patients enrolled. Patients  were  under adalimumab 40 mg EOW therapy for a 16 weeks-1 year. We observed a rapid and significiant reduction of PASI and PGA scores in W4. By week 24, 95, 45% (n=21) of patients achieved ≥PASI 75, 72, 72% (n=16)  of patients     achieved ≥PASI 90 and 40, 9% of patients achieved PASI 100 response. The percentage of patients patients who achieved a PGA ‘Clear’ or ‘Almost Clear’ was 77, 27% (n=17) at W24. Dose escalation of adalimumab provided the achievement and long-term maintenance of clinical improvement in these patients. No side effects were observed during  40 mg EW adalimumab treatment.

Conclusions: Dose escalation could be a good approach for increasing efficacy in a subgroup of patients with an insufficient response to adalimumab, reducing symptoms of psoriasis.

Open Access Original Research Article

Effectiveness of Topical Minoxidil (5%) Plus Topical Finasteride (0.1%) Fixed-Dose Combination Versus Topical Minoxidil (5%) Plus Oral Finasteride (1 Mg/Day) in Grade II-IV Androgenetic Alopecia: A Randomized, Double Blind Clinical Trial

Debatri Datta, Abanti Saha, Ramesh C. Gharami, Nilay Kanti Das, Debabrata Bandyopadhyay

Asian Journal of Research in Dermatological Science, Page 6-18

Background: Male Androgenetic Alopecia is a common hair loss disorder that increases with age. The cornerstones of medical management are minoxidil and finasteride.No treatment is completely satisfactory. 

Aims and Objectives: This study compared Topical Minoxidil 5%+Finasteride 0.1% combination (Group A) and Topical Minoxidil 5%+Oral Finasteride 1 mg/day (Group B) in treating Male Androgenetic Alopecia grade II-V by assessing efficacy and quality of life.

Materials and Methods: In this double blind randomized, controlled trial, 72 patients were randomly allocated in 2 groups of 36 to receive either of the two treatments for six months. Patients received identically colored bottles of minoxidil 5% (Group B) or minoxidil 5%+finasteride 0.1% combination (Group A) and finasteride 1 mg tablets (Group B) or identical-looking placebo tablets (Group A).Changes in subject’s self-assessment and investigator’s assessment of hair growth, and patient’s and physician’s global assessment of disease activity improvement were recorded monthly. Symptoms and adverse effects were noted monthly. Clinical photographs were taken monthly. Hamilton-Norwood scale were recorded at baseline and end of treatment.

Results: 32 patients in Group B and 30 in Group A completed treatment. Modified intention-to-treat analysis showed significant improvement in both groups from baseline to end of treatment. No significant difference was noted between two groups in any visit in subject’s self assessment, investigator’s assessment of hair growth, and patient’s and physician’s global assessment of disease activity improvement in any visit. Mild adverse effects were noted in 6.67% of Group A  and 9.37% of group B patients. Hamilton-Norwood Grade was improved in both groups and was comparable at the end of the treatment between both groups.

Conclusion: Both the treatments are equally effective without too many remarkable side effects.

Open Access Original Research Article

Assessment of Bacterial Spores and Its Related Skin Problems and to Evaluate the Effectiveness of Education Booklet on Usage of Household Washing Machine among Women’s at Selected Area

G. Bhuvaneshwari, A. Deborahl

Asian Journal of Research in Dermatological Science, Page 25-33

Introduction: Skin disorders are the most common health problems among all age group people. Skin disorders may cause emotional and psychological stress for family members but certain factors which predisposes to skin problems include personal hygiene,type of washing technique , family history of skin infections, traditional taboos etc. Bacteria enters the household washing machine via worn clothes, household linen and influent water,while the laundry process is expected to deliver both visually and hygienically clean laundry.

Aim: The present study aims to assess the skin problems and evaluate the effectiveness of education booklet on usage of household washing machine.

Methodology: One group pre test and post test design was conducted among 60 women s. a random purposive sampling technique was used to select samples. Self administered structured questionnaires were used to collect demographic data and skin problems were assessed by using DLQI scale. Bacterial count in washing machine were assessed with swaps test. Self administered structured questionnaires were used to assess the knowledge on usage of household washing machine.  The help of education booklet on usage of household washing machine were taught to women. And after teaching about usage of household washing machine knowledge level were re-assessed.

Results: The present study also shows that the demographic variable age, religion,education status, occupation, income, type of washing technique, duration of using washing machine, family history of skin infections, previous skin infection had shown statistically significant association with the post test level of knowledge on usage of household washing machine among women at p<0.001 level.

Conclusion: The study concluded  that the women knowledge level increased after educating with education booklet and also an effective method to prevent further complications that can be caused due to usage of house hold washing machine.

Open Access Review Article

Skin Bleaching Practices: Products, Mechanisms and Effects

Dasetima Altraide, Dieprebi Agnes Aladeh, Bolaji Otike-Odibi

Asian Journal of Research in Dermatological Science, Page 34-42

Skin bleaching is the use of chemical substances to lighten the colour of the skin. Despite various publications and documentaries on the harmful effects of skin bleaching, it is still becoming increasingly common especially among the black skin coloured individuals. A lighter skin has been perceived to be synonymous with beauty. Most skin lightening products are known to act on different pathways of melanin biosynthesis. The major lightening products used include hydroquinone, mercury and topical steroids which come as soaps, body wash, gels and creams. Skin lightening can cause a myriad of cutaneous and systemic adverse effects and so continuous public health awareness to sensitize individuals on the dangers of skin bleaching and proper regulations by the Government and relevant authorities must be put in place.