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   Table of Contents - Current issue
Coverpage
January-June 2022
Volume 8 | Issue 1
Page Nos. 1-54

Online since Saturday, June 11, 2022

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REVIEW ARTICLE  

Oral minoxidil in trichology: A review Highly accessed article p. 1
Priyanka Arun Kowe, Bhushan Madke, Shashank Hemant Bansod
DOI:10.4103/ijdd.ijdd_35_21  
Minoxidil, a pro-drug has been used as an oral antihypertensive drug since the 1960s. Though it was initially introduced as a therapy to control hypertension, it became popular after its coincidental finding on the promotion of hair growth and stimulation of new hair production. This has led to the usefulness of minoxidil in treating several hair loss disorders in both topical and oral forms. In 1988, Food and drug administration (FDA) approved topical minoxidil (TM) 2% for the treatment of male androgenetic alopecia (AGA) and in 1992, it got approval for female pattern hair loss (FPHL). Since then the use of TM has increased tremendously. However, there are frequent reports of TM and/or its vehicle-induced contact dermatitis which has reduced the compliance in the patients resulted in a poor outcome. Oral minoxidil (OM) has been tried and found useful in AGA, alopecia areata (AA), traction alopecia (TA), chronic telogen effluvium (CTE), chemotherapy-induced alopecia, monilethrix, and several other alopecia’s; however, the exact mechanism of action and efficacy of oral minoxidil in these disorders remains undetermined. Also, when given in low dose, side effect profile of OM has been found comparable to that of TM. The above data was supported by case series, randomized control trials, and case reports with a low quality of evidence. In this review, we aimed to summarize the different indications of oral minoxidil. We reiterate the claim that high-quality studies are needed before advocating use of oral minoxidil in hair disorders.
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ORIGINAL ARTICLES Top

Serum and sebum pharmacokinetics evaluation of a novel formulation of itraconazole in healthy volunteers p. 7
Harshal Mahajan, Gaurav K Jain, Dhiraj Dhoot, Gaurav A Deshmukh, Hanmant V Barkate
DOI:10.4103/ijdd.ijdd_23_21  
Background and Objective: Super bioavailable itraconazole is a newer formulation of itraconazole, which overcomes challenges encountered with the use of conventional itraconazole like interpatient variability, limited absorption, reduction in its absorption with co-administered gastric acid lowering agents, etc. The present study was done to evaluate the plasma pharmacokinetics, sebum concentrations of super bioavailable itraconazole in comparison with conventional itraconazole. Materials and Methods: Twelve healthy Asian Indian male healthy volunteers were enrolled in single-center, open-labeled, two treatments, multi-dose, parallel pharmacokinetic study. Test drug (T), i.e. super bioavailable itraconazole 50 mg, was given to six volunteers twice daily after meals for 7 continuous days. Reference drug (R), i.e. conventional itraconazole 100 mg, was given in similar way to the remaining six volunteers. Concentration of the itraconazole in plasma in both the groups was quantified by using high performance liquid chromatography. Concentration of the itraconazole in sebum was measured by paper absorption method. Results: The plasma concentration of itraconazole in both the groups was comparable at all-time points. The maximum concentration (Cmax) and area under curve in test group was higher as compared to reference group. The relative bioavailability of test drug was 107% as compared to the reference drug. The intersubject variability was less in test group (8.37%) as compared to reference drug (19.82%). At day 7, the mean sebum concentration of itraconazole in test drug group was 11.6% higher as compared to reference drug (P = 0.01). Conclusion: It is apparent from the study outcomes that super bioavailable itraconazole (50 mg) is bioequivalent to the conventional itraconazole (100 mg) along with less intersubject variability, and most importantly higher sebum concentration as compared to conventional itraconazole.
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Dermatological adverse events of cancer chemotherapy: An observational clinicoepidemiological study from a tertiary care center p. 15
Guneet Awal, Guramrit Singh
DOI:10.4103/ijdd.ijdd_36_21  
Introduction: Although newer chemotherapeutic drugs prolong patients’ survival, they cause a myriad of dermatological adverse effects leading to decreased quality of life. Aims and Objectives: The study was undertaken to assess the various cutaneous adverse effects associated with chemotherapeutic drugs. Materials and Methods: A total of 736 diagnosed cancer patients on chemotherapy attending the dermatology department of a tertiary care center were studied in this observational study between June 2019 and May 2021. Detailed dermatological examination to include skin, hair, nail, and mucosal changes was undertaken after informed consent. Results: The most common malignancy observed was breast carcinoma, which was seen in 21.33% of the cases. It was followed by carcinoma cervix in 12.09% of the cases. Most commonly implicated drugs were platinum therapy (cisplatin, carboplatin) and anthracyclines (doxorubicin and epirubicin). Alopecia was the most common adverse effect seen in 55.84% of the patients. It was followed by hand-foot syndrome in 11% of the patients. Nail changes were seen in 4.21% of the patients, and the most common nail finding was longitudinal melanonychia seen in 1.49% of the patients. Conclusion: Knowledge regarding occurrence and severity of dermatological side effects of chemotherapy aids in early recognition and treatment. It also benefits in educating patients regarding potential adverse effects, taking appropriate prophylactic measures, and therefore better compliance by the patient.
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BRIEF REPORT Top

A case series of generalized Lichenoid Drug Eruption due to Anti-Tubercular Drugs: Treated with immunosuppressant’s while continuing Anti-Tubercular therapy p. 23
Hari Pathave, Atul Dongre, Gayatri Gund, Sapna Goutham, Chitra Nayak
DOI:10.4103/ijdd.ijdd_65_20  
The spectrum of tuberculosis-associated cutaneous adverse drug reactions (ADRs) is wide and includes Stevens-Johnson syndrome, drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome and generalized lichenoid drug eruption (LDE). LDE constitutes less than 10% of the total incidence of anti-tubercular drug induced cutaneous ADRs. In any type of drug reaction there is a prompt need of withdrawal of suspected drugs and institution of aggressive treatment of ADRs with proper control of underlying primary disease. Herein, we present a case series of five cases of generalized LDE due to anti tubercular therapy (ATT), in whom cutaneous lesions were managed with oral immunosuppressants while continuing ATT.
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CASE REPORTS Top

Topical 5-fluorouracil for Basal Cell Carcinoma p. 29
Anil Balkrishna Bhokare
DOI:10.4103/ijdd.ijdd_20_20  
Basal cell carcinoma is a malignant epithelial tumor arising only in skin, from the basal layer of the epidermis or of the pilosebaceous adnexa. Diagnosis often depends on skin examination, confirmed by tissue biopsy. Treatment is typically by surgical removal. This can be by simple excision if the cancer is small; otherwise Mohs surgery is generally recommended. Other options may include topical chemotherapy, laser therapy, or the use of imiquimod. In this study, we conclude topical 5-fluorouracil is a highly effective and well-tolerated treatment option for superficial basal cell carcinomas.
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Pentoxifylline in the treatment of generalized granuloma annulare: A report of three cases p. 32
Vidya D Kharkar, Harish Balaji Rajendran, Anmol Bhargava
DOI:10.4103/ijdd.ijdd_15_21  
Granuloma annulare (GA) is a benign self-limited granulomatous cutaneous disorder of unknown etiology. Clinical variants include localized, generalized, perforating, and subcutaneous. Generalized or disseminated GA is an uncommon variant displaying some clinical features that differentiate it from the localized form, including later age of onset, inadequate response to treatment, and less tendency to spontaneous resolution. The treatment modalities used for localized GA (topical or intralesional steroids, freezing with liquid nitrogen, or surgical excision) cannot be successfully applied to the large numbers of lesions seen in GA’s generalized form. Systemic treatments have included dapsone, chlorambucil, isotretinoin, systemic steroids, cyclosporine, salicylates, chloroquine, and PUVA. These treatments have potentially serious side effects in the long term and have not demonstrated consistent results. Literature overuse of pentoxifylline in the treatment of GA is limited. Here we report three prospective cases of generalized GA showing resolution with oral pentoxifylline.
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LETTERS TO THE EDITOR Top

Angiolymphoid hyperplasia: Excellent response to polidocanol sclerotherapy p. 38
Vikrant M Jadhav, Anil S Gugle, Nitin G Barde
DOI:10.4103/ijdd.ijdd_51_19  
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Gratifying results of apremilast in unstable erythrodermic psoriasis p. 40
Meghana Chandrashekhar Rane, Vidya Kharkar
DOI:10.4103/ijdd.ijdd_27_21  
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Tetracyclines and niacinamide to the rescue in a case of dermatitis herpetiformis p. 43
Surender Singh, Siddhi Chikhalkar, Vidya Kharkar, Prateek Oswal
DOI:10.4103/ijdd.ijdd_32_21  
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Acute generalized exanthematous pustulosis: A case highlighting the uncommon side effect of a common anti-Covid drug doxycycline in the era of Covid-19 pandemic p. 46
Ipsita Debata, Debasmita Behera, Chinmoy Raj, Abhishek C Lachure
DOI:10.4103/ijdd.ijdd_16_21  
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Topical steroid induced central serous chorioretinopathy- a rare side-effect p. 49
Paras Choudhary, Prachi Vinayak Gole, Bhushan Amol Darkase, Balasaheb Vishwas Malkar
DOI:10.4103/ijdd.ijdd_40_20  
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Correlation between percentage of atypical lymphocytes in peripheral smear and disease severity based on internal organ involvement in drug reaction with eosinophilia and systemic symptoms p. 52
Reshma J Neerackal, Dhanya Mohan, Anand G Archana, Biju George, Aparna Govindan, Chettithodi Sivasankaran Bindu, Sarita Sasidharanpillai
DOI:10.4103/ijdd.ijdd_12_21  
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