Publications by authors named "Mahajan Rahul"

Pemphigus is an autoimmune blistering disorder characterized by the presence of intraepidermal blisters and erosions, primarily affecting the mucosa and/or skin. There are no established Indian guidelines for the management of pemphigus, and Western guidelines cannot be directly applied due to differences in clinicodemographic profiles, comorbidities, and resource limitations. These guidelines aim to provide Indian dermatologists with evidence-based and consensus-driven recommendations for the management of pemphigus vulgaris (PV) and pemphigus foliaceous (PF), taking into account the unique challenges posed by the Indian healthcare setting.

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  • Autoimmune blistering disorders (AIBD) are conditions where the body produces auto-antibodies against adhesion proteins in the skin, detectable through direct immunofluorescence (DIF) or blood tests like ELISA.
  • This study aimed to assess how well the results from a new multivariant ELISA method agreed with AIBD diagnoses established from clinical assessments, histopathology, and DIF.
  • The results showed a good overall correlation between ELISA and diagnoses, particularly strong in pemphigus vulgaris, but with variable agreement levels in other types of AIBD and limitations due to the retrospective nature of the study.
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  • Epidermolysis bullosa (EB) is a genetic condition that causes blisters to form easily on the skin, either spontaneously or due to injury, leading to scarring and color changes in the skin.
  • A child with this condition exhibited extensive areas of lighter skin, frequent blistering in vulnerable spots, and issues with nail growth.
  • The case highlights the difficulty in differentiating between epidermolysis bullosa and another skin disorder called bullous extragenital lichen sclerosus et atrophicus.
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  • Skin conditions are prevalent but poorly managed, especially due to a shortage of dermatologists and unequal healthcare access between urban and rural areas.
  • The objective was to create standard treatment workflows (STWs) for common skin diseases to help healthcare providers at all levels deliver better care.
  • Thirteen modules covering various skin conditions were developed and are now available as posters in health centers and online, aiming to improve the treatment of skin diseases throughout the healthcare system.
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  • Pemphigus during pregnancy poses risks for both the mother and fetus, often worsening in the first two trimesters due to its autoimmune nature.
  • Fetal complications can include stillbirth and neonatal pemphigus, which result from the transfer of autoantibodies through the placenta.
  • Individualized management and counseling for women with pemphigus are essential to balance treatment risks and benefits, particularly since severe cases increase the likelihood of adverse outcomes for both mother and child.
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  • The study investigates the relationship between skin pigmentation changes in systemic sclerosis and the severity of cutaneous sclerosis as well as internal organ involvement.
  • It found that patients with pigmentary alterations had significantly higher modified Rodnan skin scores, indicating more severe skin involvement.
  • While most patients had lung complications, those with skin pigmentation exhibited lower scores on high-resolution CT scans, suggesting a complex interaction between skin changes and organ health.
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  • A 70-year-old woman had a single wart-like growth on her leg and painful sores in her mouth.
  • Doctors considered possible conditions like lichen simplex chronicus and chromoblastomycosis before diagnosing her with pemphigus vegetans (PVeg).
  • This case emphasizes the need to include PVeg in diagnoses for unusual skin growths, even when they appear in unexpected areas of the body.
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Secondary amyloidosis may complicate inherited dermatoses, but recessive dystrophic epidermolysis bullosa (RDEB) complicated by renal amyloidosis is rare. We report a case of a 12-year-old male child with RDEB presenting with progressive generalized anasarca for 20 days. Kidney biopsy showed diffuse expansion of mesangial matrix by pale acellular Periodic Acid-Schiff (PAS)-negative amorphous material, which was congophilic on Congo red stain and gave apple green birefringence on polarization and extending along the glomerular basement membrane, suggestive of amyloidosis.

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Background Mucous membrane pemphigoid (MMP) is a rare subepidermal autoimmune blistering disorder. The clinical and demographic parameters of this disease in Indian patients have not yet been elucidated in detail. Objective We aimed to study the clinical and demographic characteristics, disease course, and treatment aspects of MMP patients.

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Introduction: Epidermolysis bullosa (EB) encompasses rare hereditary skin conditions marked by skin fragility, nail dystrophy, and minor trauma-induced skin blisters. This study aims to identify genetic variants in Indian EB patients and examine the relationship between genotypic and phenotypic manifestations.

Material And Method: EB patients seen consecutively over a period of 5 years at Outpatient Department of Dermatology.

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  • * A literature review was conducted to develop a user-friendly diagnostic algorithm to help clinicians identify these disorders and determine appropriate genetic testing.
  • * The research included a comprehensive search of databases, resulting in 625 relevant articles that discuss the different diseases and contributed to forming a clear approach for provisional diagnosis based on specific clinical factors.
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  • The study investigates the relationship between segmental infantile hemangiomas (SIH) and Blaschko lines, which are patterns of mosaicism observed on the skin.
  • It involved comparing images of facial SIH from 8 patients to images of other facial dermatoses from 6 patients, using Photoshop to measure how much the lesions overlapped with Blaschko lines.
  • The results showed that SIH had a significantly lower overlap with Blaschko lines (about 73%) compared to other conditions (about 90%), suggesting that SIH does not follow the typical mosaic pattern.
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Background: Prospective research is lacking on the utility of plucked hair outer root sheath direct immunofluorescence (ORS DIF) in the prediction of relapse in pemphigus vulgaris (PV) and the correlation of ORS DIF positivity with serum desmoglein antibody titers.

Methods: We performed a prospective cohort study enrolling 80 PV patients in complete clinical remission at a tertiary care center in North India. Study participants underwent ORS DIF at baseline, which was repeated every 3 months.

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Infantile hemangioma (IH), the most common vascular tumor in pediatrics, is thought to arise from aberrant stem cell responses to stimuli such as hypoxia. This review explores the diverse manifestations, complications, and management strategies for IH, emphasizing the importance of a multidisciplinary approach. The epidemiology and risk factors associated with IH, including connections to prematurity, low birth weight, and family background, are discussed.

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  • * Their development involves genetic factors, particularly somatic mutations and disrupted signaling pathways, influencing how they present clinically—from cosmetic issues to serious health risks.
  • * Diagnosis relies on imaging techniques like MRI and CT, while treatment strategies include both traditional methods (like surgery) and new options (like targeted therapies), highlighting the necessity for personalized approaches for better patient outcomes.
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RASopathies refers to the group of disorders which are caused by a mutation in various genes of the RAS/MAPK (RAT sarcoma virus/Mitogen activated protein kinase) pathway. It includes many genes with varied functions, which are responsible for cell cycle regulation. As the mutation in one gene affects the entire pathway, there are many overlapping features among the various syndromes which are included under an umbrella term "RASopathies.

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Ectodermal dysplasias are a heterogeneous group of disorders that are characterized by abnormal development of ectodermal structures like hair, teeth, nails, and sweat glands. Alhough they were earlier classified according to the structures affected and hence the clinical manifestations, recent developments inch towards a genetic basis for classification. They are currently divided into four groups of disorders based on the pathway involved, which includes the ectodysplasin/nuclear factor-kappa B (NFKB) pathway, wingless-type MMTV integration site family, member 10 ([wingless related integration site] WNT10), tumor protein p63 (TP63), and the structural group.

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Background Owing to the lack of standardised audio-visual (A-V) instructions to take photographs, patients with pemphigus faced difficulties during tele-consultation in COVID-19 pandemic. Objective To construct and validate an A-V instruction tool to take photographs of skin and oral cavity lesions of pemphigus. Methods In this observational study, we included patients with pemphigus of either gender seeking tele-consultation, aged 18 years or older.

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