Spectrum of sensitive skin in India: a collaborative expert position statement

IntroductionSensitive skin poses a significant dermatological concern in India, influenced by diverse climatic conditions, cultural practices, and pollution levels. These factors contribute to the prevalence of sensitive skin, which is characterized by symptoms such as redness, itching, and dryness. Sensitive skin is better understood as a distinct syndrome rather than a linear progression from dry skin to conditions like acne, atopic dermatitis, and rosacea. The condition impacts the overall quality of life of affected individuals, making it crucial to understand its spectrum and management.MethodsA panel of 12 dermatologists from various regions of India provided expert insights into the characterization of sensitive skin. The dermatologists discussed the spectrum of sensitive skins and provided strategies for managing the condition. Their recommendations emphasized the importance of individualized skincare regimens tailored to the specific needs of patients.ResultsSeveral studies have discussed the heterogeneity of sensitive skin, indicating the complexity of its diagnosis and management. The market is saturated with a variety of cosmeceuticals aimed at addressing sensitive skin. However, there are no established guidelines for using these products, leading to the adoption of individualized skincare regimens as the most common approach.DiscussionThis expert paper highlights the necessity of recommending cosmeceuticals in managing sensitive skin and emphasizes the importance of personalized skincare regimens. By comprehensively addressing the spectrum of sensitive skin, clinicians can prevent the progression to severe dermatological conditions, thereby safeguarding the skin barrier and improving the overall quality of life for individuals affected by sensitive skin

Borderline tuberculoid hansens with type 1 reaction in a HIV patient: an IRIS phenomenon over an unusual site

&lt;p class="abstract"&gt;Immune reconstitution inflammatory syndrome (IRIS) is an acute symptomatic expression of a latent infection during the recovery of the immune system and it occurs as a response to antiretroviral therapy. Opportunistic infections can act as a trigger for IRIS. Hansens disease is an infection caused by &lt;em&gt;Mycobacterium leprae&lt;/em&gt;. There are very few case reports reporting the development of borderline tuberculoid hansens with type 1 reaction as IRIS. We here report a unique case of IRIS in a HIV patient who presented with borderline tuberculoid leprosy with type 1 lepra reaction presenting over unusual site following highly active antiretroviral therapy administration.&lt;/p&gt;</jats:p

Study on treatment regimes using low dose Tranexamic acid for longer duration along with oral antioxidants, topical broad spectrum sunscreen and newer safer depigmenting topical agents in refractory Melasma patients with history of topical steroid abuse

&nbsp; Melasma is a common dermatological pigmentary disorder that can be very difficult to treat. Topical bleaching agents and stringent photoprotection, along with other treatment modalities, such as chemical peels and laser treatments, have been shown to provide only minimal improvements in this dyspigmentation. Of late, tranexamic acid has shown promise. Usage of different formulations of tranexamic acid-like topical, intradermal, and oral have been studied for Melasma, with oral formulations demonstrating the highest, although temporary, improvement. The efficacy of oral Tranexamic acid in the daily dose of 500mg for 3 to 6 months in Melasma patients has been established in various studies. Documented evidence of side effects with a higher dose of Tranexamic acid is present. There are also many published articles on the efficacy of oral sunscreens and antioxidants in preventing the exacerbation of Melasma in various studies. Topical corticosteroids (TCS) are widely misused on face especially by patients of refractory Melasma. Such patients cannot tolerate topical creams with strong bleaching agents. There are many topical agents which help in the treatment of Melasma without using topical steroids or strong bleaching agents like Hydroquinone which are misused by the rural population who visit our DVL outpatient department. Oral Tranexamic acid at a dose of 500 mg in 2 divided doses will give a response but recurrence after stopping the drug after 6 months usage occurs. In this study oral Tranexamic acid dose has been reduced and an oral antioxidant like Vitamin C, Lycopene, Red Orange Complex, Polypodium Leucotomos has been added in refractory Melasma patients to reduce the side effects of oral Tranexamic acid and without compromising its efficacy, as an adjunct in the treatment of Melasma;&nbsp; along with the use of broad spectrum sunscreen spf 50 plus which blocks both Ultraviolet radiation and visible light and milder topical agents containing Silymarin, PteroWhite, Soy extract, Niacinamide, Kojic acid and Mandelic acid which can be well tolerated on patients with a history of steroid abuse delivering promising results

Congenital atrichia associated with nevus flammeus: A rare association

Congenital atrichia is the absence of hair over the entire body at birth, an inherited condition that may be isolated or associated with other anomalies. Herein we report a case of isolated congenital atrichia with nevus flammeus

Expert consensus on defining sensitive skin and role of cosmeceuticals: an Indian perspective

&lt;p class="abstract"&gt;In clinical practice, the ‘sensitive skin’ phenomenon, encompassing a wide range of signs and symptoms, is majorly a self-diagnosed condition. Various articles have given perspective on the heterogeneous concept of sensitive skin in varied ways. Cosmeceuticals, commonly used for sensitive skin, contain biologically active ingredients that deliver multifunctional skin benefits. Since no guidelines have been formulated for the use of cosmeceutical products in the management of sensitive skin, an individualized skin care regimen is usually adopted. Also, cosmeceutical products have been demonstrated to play a crucial role as add-on therapy in the management of dermatological disorders. However, there exists uncertainty about sensitive skin manifestation and well-defined use of cosmeceuticals for sensitive skin. This paper provides a consensus clinical viewpoint of expert clinicians, which will help clear the pathway for effective identification and management of sensitive skin using cosmeceuticals.&lt;/p&gt;</jats:p

Expert consensus statement on diagnosis and management of sensitive skin in current clinical practice

&lt;p class="abstract"&gt;Sensitive skin is a very commonly seen entity in current dermatological practice that has a significant impact on quality of life. The pathophysiology, classification, diagnosis, and treatment of sensitive skin have evolved over the years, with new studies trying to bring about new robust evidence about the same. The current consensus aims at providing a comprehensive overview on evidence and experience-based approaches for sensitive skin. A total of 35 experts in the field of clinical dermatology participated in expert group meetings organized via teleconference webinar. Current evidence elaborating various aspects like classification, diagnosis, and management of sensitive skin along with clinical experience of experts were discussed in detail. The prerequisites for selecting suitable products, importance of cosmeceuticals as adjunctive therapy and the need for avoiding triggering factors in individuals with sensitive skin as well as associated dermatological disorders were also described. In addition to medical history, physical examination and routine investigations, a draft checklist and its clinical relevance in accurately diagnosing sensitive skin were emphasized upon by the experts. The overall management encompasses avoidance of individual trigger factors, thorough topical therapy using mild, non-irritating ingredients along with adjunctive therapies like moisturizers, sunscreens, and cleansers. The “two-week” strategy was described to be a useful approach for treating sensitive skin. This review article provides a consensus clinical viewpoint of expert dermatologists for effective evaluation, differential diagnosis and appropriate pharmacological as well as non-pharmacological management of sensitive skin in Indian subjects.&lt;/p&gt;</jats:p