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Baricitinib is a competitive inhibitor of the Janus Kinase family of non-receptor protein kinases, predominantly acting against JAK-1 and JAK-2 subtypes. By downregulating transcription of various pro-inflammatory cytokines, this drug has shown efficacy across various dermatoses. Approved for severe cases of alopecia areata and moderate-severe atopic dermatitis in adults, baricitinib is being increasingly tried across many other indications with promising results. It is prudent that dermatologists remain aware of boxed warnings and precautions with the use of this much-discussed molecule, including its infectious, thrombotic, cardiovascular, and malignant ramifications. Long-term data on the use of baricitinib in dermatological conditions are lacking and further research is warranted since most data on safety profile is extrapolated from its use in rheumatology. The present review aims to highlight the immunopathogenic mechanisms of JAK-1/2 blockade, approved and off-label uses in dermatology, along with a concise review of laboratory monitoring and the side-effect profile of baricitinib. [ABSTRACT FROM AUTHOR]

The effectiveness of forest honey in Total Nasal Symptom Score (TNSS) improvement in allergic rhinitis patients and index Scoring Atopic Dermatitis (SCORAD) in Atopic Dermatitis (AD) patients were discovered. It was an experimental study with a pretest–posttest design. A total of 20 people with atopy (15 people with allergic rhinitis and five people with AD) were given forest honey in the morning (1 ml × 10 ml dose) for 8 weeks and 20 atopy patients without forest honey. TNSS and SCORAD index were evaluated before the intervention, week 2, week 4, and after the intervention (week 8). The mean TNSS before treatment was higher in the honey group, namely 7.73, and a significant decrease after 8 weeks of intervention, namely 2.73 with P = 0.000. The nonhoney group showed that there was no significant difference after 8 weeks with P = 0.888. The SCORAD values of the honey and nonhoney groups had significantly different values from week 0 to week 4 (P = 0.003) and week 0 to week 8 (P = 0.003). Forest honey can give as an additional therapy for patients with allergic rhinitis and AD. [ABSTRACT FROM AUTHOR]

Atopic dermatitis is a chronic inflammatory dermatological condition associated with intense pruritus seen in all age groups and ethnic diversities. It can have a significant impact on the quality of life. The options for treatment include skincare, topical therapies, systemic therapies, and phototherapy. Treatment of atopic dermatitis may be associated with several challenges including suboptimal efficacy, risk of adverse events, and limited patient satisfaction. A better understanding of the pathophysiology of atopic dermatitis has resulted in the evaluation of many treatment options. Phosphodiesterase 4 plays a role in the pathogenesis of atopic dermatitis and hence can be a target for treatment. Crisaborole 2% ointment is a phosphodiesterase 4 enzyme inhibitor approved for the treatment of mild-to-moderate atopic dermatitis in patients above 2 years of age by the USFDA. Currently, it is not approved for use in Indian patients. In this article, the role and potential place of crisaborole in the management of atopic dermatitis in Indian patients based on global experience and evidence is discussed. [ABSTRACT FROM AUTHOR]

Tofacitinib, an oral Janus kinase inhibitor (Jakinib), is an emerging treatment modality whose well-established efficacy in systemic inflammatory diseases is now being actively explored for cutaneous disorders (arising due to the patient's dysimmune responses) that are not responding to and/or sustaining intolerable adverse effects with the classical immunosuppressives and other targeted therapies such as the biologics. The most common dermatoses for which oral as well as topical Jakinibs such as tofacitinib have been evaluated and are being used albeit as an off-label indication include psoriasis, psoriatic arthritis, alopecia areata, vitiligo, and atopic dermatitis. This article provides a succinct review on the current status of oral tofacitinib in dermatology through literature search of PubMed database and stresses on the need for further evidence generation to define the drug's place in the therapeutic arsenal of dysimmune cutaneous disorders. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is an intriguing clinical entity. Its clinical connotations are varied, the updates of which are required to be done periodically. An attempt to bring its various facets have been made highlighting its clinical features keeping in view the major and the minor criteria to facilitate the diagnosis, differential diagnosis, complications, and associated dermatoses. The benefit of the current dissertation may percolate to the trainees in dermatology, in addition to revelations that atopic undertones in genetic susceptibility and metabolic disorder may provide substantive insight for the future in the understanding of thus far enigmatic etiopathogenesis of AD. [ABSTRACT FROM AUTHOR]

Objective: The impact of occupational contact dermatitis (OCD) is often underestimated because of underreporting, and its management is also inadequate, especially in developing countries. Topical corticosteroids have remained the first line treatment but till date, there is no study on efficacy and safety of halometasone in OCD, and there is a paucity of data on its comparative efficacy in allergic and irritant variety. This study aims to evaluate the efficacy and safety of halometasone in OCD and to compare its effect in allergic and irritant types of OCD. Methods: The present study is a prospective, interventional, single arm clinical study conducted on 150 patients of OCD. Detailed history and clinical examination was done at baseline, and all enrolled patients underwent patch test with the Indian Standard Battery of allergens. Eczema severity was assessed by the Investigator's Global Assessment (IGA) scale, SCORing Atopic Dermatitis (SCORAD) index, and patient-oriented eczema measure (POEM). Change in quality of life was assessed by using the Dermatology Life Quality Index (DLQI). After baseline assessments, they were prescribed halometasone 0.05% ointment and were followed up after 4 weeks, and efficacy variables were evaluated. Results: At follow-up, 19 patients were lost, and data of 131 patients were analyzed. After 4 weeks of halometasone therapy, there was statistically significant (P < 0.001) improvement in SCORAD index, IGA, POEM, and DLQI. Considering improvement in IGA as treatment success criteria, treatment was found to be successful in 87.8%. Subgroup analysis revealed no significant difference in effect of halometasone in allergic and irritant OCD. Conclusions: Halometasone is efficacious with a good safety profile in patients with OCD, and there is no significant difference in efficacy of the drug in allergic and irritant OCD. [ABSTRACT FROM AUTHOR]

Background: Dermatological patients invariably suffer one or the other psychological problems which may escalate to the extent of a mental disorder. One of the most common dermatological disorders is atopic dermatitis (AD), but the literature has limited data on gender differences for psychiatric morbidity in such patients. Aims: To evaluate and compare gender differences in the prevalence of depression and anxiety in AD. Materials and Methods: This cross‑sectional study with consecutive sampling was done in an outpatient clinic of Dermatology at a Tertiary Care Center. AD subjects giving informed consent were evaluated on a brief semi‑structured performa for collecting demographic and clinical information. Primary Care Evaluation of Mental Disorders (PRIME‑MD) was used to assess the presence of psychiatric symptoms in these patients. Descriptive analysis was done for the socio‑demographic profile and independent sample t‑test, Chi‑square and Cramer's V test was carried out to find in‑between group differences for males and females. Results: A total of 81 patients were included in the final analysis (males = 36, females = 45) with no significant difference in mean age between male and female subjects (36.14 ± 17.62 and 33.98 ± 14.49 years, respectively; P = 0.54). When including moderate to severe grade of depression or anxiety, the current study found prevalence rates of 15% and 12% respectively. Females had significantly more anxiety and depression scores than males (P = 0.04 and P = 0.03 respectively). Conclusions: There is a female preponderance of depression and anxiety disorder in AD patients. [ABSTRACT FROM AUTHOR]