Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

Turkish Journal of Dermatology. Conference: 21st Congress of the European Society for Dermatology and Psychiatry and 1st World Congress of Psychodermatology. Istanbul Turkey. 19(1 Supplement 1) (pp 95), 2025. Date of Publication: 01 May 2025.

Abstract:

Aim: Chronic dermatological conditions such as psoriasis, atopic dermatitis, and hidradenitis suppurativa exhibit a complex interplay between neuroinflammation and psychological distress. The bidirectional relationship between cutaneous inflammation and psychiatric morbidity suggests that systemic inflammatory mediators play a pivotal role in exacerbating both dermatological and psychiatric symptoms. This abstract explores existing literature on neuroinflammation in psychodermatology, highlighting its impact on disease progression and mental health comorbidities. Material(s) and Method(s): A comprehensive review of peer-reviewed literature from PubMed, Scopus, and Embase was conducted to assess the role of neuroinflammatory pathways in dermatological conditions. Studies analyzing inflammatory biomarkers, neuroimmune interactions, and psychodermatological interventions were included. The review focused on the correlation between inflammatory markers and psychiatric distress in patients with chronic skin disorders. Result(s): Existing studies indicate a significant association between elevated inflammatory markers (interleukin-6, tumor necrosis factor-alpha, C-reactive protein) and increased psychiatric distress in chronic skin conditions. Psychological interventions such as cognitive-behavioral therapy and stress-reduction techniques demonstrate potential in modulating inflammation and improving patient-reported outcomes. Emerging therapeutic approaches targeting the neuroimmune axis, including biologic agents and psychoneuroimmunological interventions, are also discussed. Conclusion(s): This review highlights the integral role of neuroinflammation in psychodermatology and underscores the need for a multidisciplinary approach to managing chronic dermatological disorders. Future research should explore targeted neuroimmune therapies and integrative mental health interventions to optimize patient care and quality of life in psychodermatology.

Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

Turkish Journal of Dermatology. Conference: 21st Congress of the European Society for Dermatology and Psychiatry and 1st World Congress of Psychodermatology. Istanbul Turkey. 19(1 Supplement 1) (pp 94), 2025. Date of Publication: 01 May 2025.

Abstract:

Aim: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder with profound psychological consequences. Patients experience significant social stigma, depression, and reduced quality of life due to recurrent painful lesions and scarring. This abstract reviews the current literature on the psychological burden of HS and the importance of incorporating mental health care in disease management. Material(s) and Method(s): A review of published studies from PubMed and Embase was conducted to assess the psychological impact of HS. Research on depression, anxiety, social withdrawal, and dermatology life quality index scores in HS patients was analyzed. The review also explored potential benefits of psychodermatological interventions. Result(s): Studies highlight that 40%-50% of HS patients experience moderate-to-severe depression, with a high incidence of anxiety and social isolation. HS is associated with an increased risk of suicidal ideation compared to other dermatological conditions. Multidisciplinary management incorporating dermatologists, psychologists, and pain specialists has shown promise in improving patient outcomes. Conclusion(s): The psychological burden of HS is often overlooked in standard dermatological care. Early screening for mental health conditions and the inclusion of psychotherapeutic support should be prioritized in HS management. Future research should focus on the efficacy of integrated psychodermatology approaches to improve quality of life in HS patients.

Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

Turkish Journal of Dermatology. Conference: 21st Congress of the European Society for Dermatology and Psychiatry and 1st World Congress of Psychodermatology. Istanbul Turkey. 19(1 Supplement 1) (pp 153), 2025. Date of Publication: 01 May 2025.

Abstract:

Aim: The increasing prevalence of social media has contributed to heightened appearance-related anxiety and unrealistic beauty standards, leading to a phenomenon known as "filter dysmorphia". This abstract explores existing literature on the impact of digital media on acne dysmorphia, social anxiety, and dermatological self-perception. Material(s) and Method(s): A literature review was conducted on studies examining the psychological impact of social media exposure on skin-related concerns. Research on acne dysmorphia, social anxiety disorder, and the influence of digital filters on self-image was analyzed. Result(s): Evidence suggests that excessive social media engagement correlates with increased acne-related anxiety, negative self-perception, and a higher likelihood of seeking unnecessary dermatological interventions. Filter dysmorphia appears to contribute to an increase in perceived acne severity, despite objective clinical findings remaining unchanged. Conclusion(s): Dermatologists should be aware of the psychological influence of digital media on patient self-perception and incorporate screening tools for acne dysmorphia and social anxiety in clinical practice. Future research should explore the role of media literacy programs and psychological interventions in mitigating the negative impact of digital media on dermatological concerns.

Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

Turkish Journal of Dermatology. Conference: 21st Congress of the European Society for Dermatology and Psychiatry and 1st World Congress of Psychodermatology. Istanbul Turkey. 19(1 Supplement 1) (pp 96), 2025. Date of Publication: 01 May 2025.

Abstract:

Aim: Autoimmune bullous dermatoses (ABD), including pemphigus vulgaris and bullous pemphigoid, are associated with significant physical and psychological distress. The chronic nature of these conditions, coupled with the adverse effects of long-term immunosuppressive treatment, places a considerable burden on mental health. This abstract reviews the role of psychodermatology in the holistic management of ABD patients and the need for integrated psychological support. Material(s) and Method(s): A literature review was conducted using PubMed and Scopus databases to analyze studies evaluating the psychological impact of ABD. Research on anxiety, depression, and quality-of-life measures in patients undergoing long-term immunosuppressive therapy was included. The review also assessed interventions such as psychotropic medications, cognitive-behavioral therapy, and patient support groups. Result(s): Findings indicate a high prevalence of psychiatric comorbidities among ABD patients, including depression (35%-50%) and anxiety (30%-45%). Psychological distress contributes to reduced treatment adherence and worsened disease prognosis. Evidence suggests that integrating psychodermatological care, including psychotherapy and psychiatric evaluation, improves patient-reported outcomes and treatment compliance. Conclusion(s): Despite the significant psychological burden in ABD patients, psychodermatology remains underutilized in their management. Future research should explore standardized screening for psychiatric distress in ABD and assess the long-term benefits of psychodermatological interventions. Dermatologists should consider integrating mental health support into routine care to enhance patient well-being.

Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

Turkish Journal of Dermatology. Conference: 21st Congress of the European Society for Dermatology and Psychiatry and 1st World Congress of Psychodermatology. Istanbul Turkey. 19(1 Supplement 1) (pp 96), 2025. Date of Publication: 01 May 2025.

Abstract:

Aim: Trichotillomania (TTM) and stress-related hair loss significantly impact quality of life and are often resistant to conventional dermatological treatments. Understanding the psychological mechanisms underlying compulsive hair-pulling and stress-induced alopecia is essential for improving patient outcomes. This abstract presents a review of literature on integrated treatment approaches for TTM and psychogenic alopecia. Materials and Methods: A literature review of PubMed and Cochrane databases was conducted, focusing on treatment modalities combining dermatological and psychological interventions. Studies assessing cognitive-behavioral therapy (CBT), mindfulness-based therapies, and pharmacological interventions for TTM were included. The review also examined adjunctive dermatological therapies such as low-level laser therapy and platelet-rich plasma. Result(s): Studies indicate that CBT and habit-reversal training are among the most effective psychological treatments for TTM. Emerging evidence suggests that mindfulness techniques and pharmacological agents, such as selective serotonin reuptake inhibitors, can complement dermatological therapies. Integrated management strategies, incorporating both psychiatric and dermatological interventions, show superior outcomes compared to monotherapy. Conclusion(s): Multimodal treatment approaches addressing both the psychological and dermatological aspects of TTM and psychogenic hair loss yield better patient outcomes. Dermatologists should consider collaborative care models incorporating psychiatric support to optimize treatment efficacy. Further research into novel therapeutic interventions is warranted.

Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

Turkish Journal of Dermatology. Conference: 21st Congress of the European Society for Dermatology and Psychiatry and 1st World Congress of Psychodermatology. Istanbul Turkey. 19(1 Supplement 1) (pp 142), 2025. Date of Publication: 01 May 2025.

Abstract:

Aim: Body dysmorphic disorder (BDD) is a psychiatric condition with a significant impact on cosmetic dermatology. The increasing accessibility of aesthetic procedures has led to concerns regarding undiagnosed BDD in patients seeking cosmetic enhancements. This abstract explores the literature on the prevalence, screening methods, and management strategies for BDD in cosmetic dermatology settings. Material(s) and Method(s): A systematic review of literature from PubMed and Embase was conducted to evaluate validated screening tools for BDD in dermatological practice. Studies examining the psychological impact of aesthetic interventions on BDD patients were analyzed. The review also assessed proposed multidisciplinary management strategies incorporating psychiatry and dermatology. Result(s): Findings suggest that BDD is underdiagnosed in dermatology settings, with prevalence rates ranging between 9-15% in cosmetic patients. Psychological distress often worsens post-intervention in untreated BDD cases. Screening tools such as the BDD Questionnaire and structured psychiatric assessments can improve early detection. Multidisciplinary collaboration between dermatologists and mental health professionals is essential for optimizing patient outcomes and preventing unnecessary procedures. Conclusion(s): Recognizing BDD in cosmetic dermatology is crucial to avoid worsening psychological distress in vulnerable patients. Implementing routine screening and referral pathways for psychiatric assessment can improve patient care. Future research should focus on standardized screening protocols and therapeutic interventions tailored to dermatology patients with suspected BDD.

Type of publication:

Conference abstract

Author(s):

*Ahmadi Y.

Citation:

Journal of Investigative Dermatology. Conference: 54th ESDR 2025 Meeting. Antwerp Belgium. 145(12 Supplement) (pp S341), 2025. Date of Publication: 01 Dec 2025.

Abstract:

Mammary Paget's disease (MPD) or Paget's disease of the breast is a rare dermatological malignancy of the nipple-areolar complex that manifests with a spectrum of symptoms spanning from itching and redness to more severe indications such as breast lump, nipple-areolar complex destruction, or nipple discharge. It is predominantly associated with an underlying ductal carcinoma in situ or invasive ductal carcinoma. MPD often masquerades as other benign and malignant dermatological conditions, including eczema, atopic dermatitis, psoriasis, and squamous and basal cell carcinomas, leading to delayed diagnosis and inappropriate treatment. Only one-third of the patients present with a palpable lump; therefore, advanced age with chronic and unilateral lesions should raise concern for MPD. Our review article presents case reports of MPD imitating other skin conditions and underscores the key findings of clinical features and diagnostic workup to help differentiate the condition. A literature review revealed that studies emphasize caution regarding the sole use of mammography and ultrasound in diagnosing MPD, particularly in cases lacking a palpable lump. This highlights the MRI as a superior and more accurate imaging tool. However, any suspicious lesion must be biopsied to allow histopathological and immunohistochemical examination, since there are some cases where MRI findings were negative in the presence of a biopsy-proven MPD. This highlights the need for clinicians to investigate any suspicious lesion of the nipple or breast using the complete triple assessment approach to exclude an underlying malignancy. It is imperative to establish therapeutic guidelines to approach any nipple lesion to minimize the risk of misdiagnosing any underlying cancer, which can be potentially fatal if left alone.

DOI: 10.1016/j.jid.2025.10.439

Type of publication:

Journal article

Author(s):

Bajaj, Sonali; Desai, Prachi; Singh, Akanksha; *Jain, Dimple; Wahie, Shyamal.

Citation:

Clinical & Experimental Dermatology. 2026 Feb 10. [epub ahead of print]

Abstract:

BACKGROUND: Narrowband UVB (NBUVB) is a second-line treatment for chronic moderate-to-severe atopic eczema unresponsive to adequate topical therapy, and is known to induce good short-term improvement of eczema severity. However, it is unclear how adult patients fare with their eczema severity long after completion of a course of NBUVB.

OBJECTIVES: We aimed to investigate the severity of atopic eczema in adults, 1 year following completion of NBUVB, using validated clinical activity measures.

METHODS: We undertook a multi-centre prospective observational study of adults with moderate-to-severe atopic eczema who were prescribed NBUVB as part of their standard clinical care. Assessments were made at baseline prior to starting NBUVB, at the end of NBUVB and at 4, 8 and 12 months after completion of NBUVB.

RESULTS: Eighty participants with moderate-to-severe atopic eczema (mean SCORAD 39.2, POEM 18.5, IGA 3.2) underwent NBUVB therapy. Significant reductions were observed post-treatment: SCORAD decreased to 17.8, POEM to 8.2, and IGA to 1.7 (p<0.001 achieved for all time points). These therapeutic effects were sustained at 4, 8, and 12 months post-treatment (n=27 at 12 months). Loss of follow-up was attributed to non-attendance exacerbated by the COVID-19 pandemic and patient relocation. Mild adverse events (n=5), including erythema and eczema flares, were reported, with no serious events.

CONCLUSIONS: These findings indicate that NBUVB may provide a long-lasting effect for patients who complete a course, helping to diminish their eczema severity to a more manageable level.

DOI: 10.1093/ced/llag066

Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

British Journal of Dermatology. Conference: 105th Annual Meeting of the British Association of Dermatologists, BAD 2025. Glasgow United Kingdom. 193(Supplement 1) (pp i54), 2025. Date of Publication: 01 Jul 2025.

Abstract:

Trichoscopy has emerged as a pivotal diagnostic tool for evaluating scalp disorders. This systematic review assesses its diagnostic sensitivity, specificity and accuracy for various scalp conditions, proposing refinements to clinical protocols based on National Institute for Health and Care Excellence (NICE) and British Association of Dermatologists (BAD) guidelines. The aim is to provide recommendations for integrating trichoscopy into routine dermatology practice to optimize patient outcomes and diagnostic pathways. A systematic review was conducted following the PRISMA guidelines. The PubMed, MEDLINE and Embase databases were searched for studies published between 2010 and 2023. Keywords included 'trichoscopy', 'scalp disorders', 'diagnostic accuracy', 'sensitivity' and 'specificity'. Inclusion criteria encompassed studies evaluating the diagnostic performance of trichoscopy for common scalp conditions such as alopecia areata, androgenetic alopecia, telogen effluvium, scalp psoriasis, seborrhoeic dermatitis and tinea capitis. Only multicentre or single-centre studies with quantitative data were included. Exclusions included case reports and studies lacking statistical metrics. Data were analysed within the framework of the BAD and NICE recommendations to assess real-world applicability. Thirty-six studies involving 11 250 patients were included. Trichoscopy consistently demonstrated high diagnostic accuracy, surpassing traditional methods. (i) In alopecia areata, exclamation-mark hairs and black dots yielded 94% sensitivity and 92% specificity, aligning with BAD recommendations. (ii) In androgenetic alopecia, hair shaft diameter variability and perifollicular pigmentation showed 91% sensitivity and 89% specificity, supporting diagnostic integration. (iii) In telogen effluvium, empty follicles and short regrowth hairs demonstrated 86% sensitivity and 84% specificity, enabling earlier interventions. (iv) In tinea capitis, comma hairs and corkscrew hairs achieved 95% diagnostic accuracy, emphasizing the superiority of trichoscopy. (v) In scalp psoriasis and seborrhoeic dermatitis, differentiation was achieved using red dots, diffuse white scales and arborizing vessels, with 92% sensitivity. Reproducibility across centres was evident. Artificial intelligence (AI)-based algorithms were highlighted for enhancing diagnostic standardization, clinician training and accessibility. A national registry of trichoscopic images is proposed to improve data sharing and compliance with guidelines. In conclusion, trichoscopy is indispensable for diagnosing scalp disorders, offering a noninvasive, accurate alternative to biopsies. It enables earlier diagnosis, precise differentiation and improved outcomes, aligning with NICE and BAD guidelines. The results support the following recommendations. (i) Develop standardized trichoscopic criteria for scalp disorders. (ii) Include trichoscopic education in dermatology training. (iii) Invest in AI-based tools for image standardization. (iv) Establish a national trichoscopy registry for collaborative research. For application to clinical practice, this review provides actionable insights for enhancing diagnostic pathways and advancing the role in dermatology in trichoscopy, offering a foundation for improved patient care.

DOI: 10.1093/bjd/ljaf085.105

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