Komal Doshi's scientific contributions

Background: Seborrheic dermatitis is a common chronic inflammatory skin disorder that affects the scalp and is characterized by erythema and oily scales. It could perhaps be difficult to control and could seriously degrade one's quality of life. The study's objective is to assess the effectiveness of intradermal administrations of QR678 Neo® hair growth factor therapy for the treatment of scalp seborrheic dermatitis in both men and women. Method: Forty male and female patients with clinically diagnosed seborrheic dermatitis of the scalp in the age 18-45 years, not satisfactorily responding to standard therapy for at least 6 months, were included. 1 mL solution of QR678 Neo® was administered in the scalp skin of all patients at 3-week interval till eight sessions. Patients were advised to continue with antifungal shampoo and topical antifungal solution with steroid combination which they had been on during the treatment. Assessment of disease severity, dermoscopic evaluation, and self-assessment were done at baseline and at the end of the fourth and the eighth sessions. Results: Improvement was observed in adherent scalp flaking score after eighth session (mean = 12) compared to baseline (mean = 60). The dermoscopic evaluation showed a noticeable difference from baseline (mean = 11) in erythema and scaling with the Seborrheic Dermatitis Scalp Severity Index tool at the end of treatment (mean = 2). A high satisfaction score was given for the efficiency in the self-assessment questionnaire. Conclusion: Our study proved that treatment with QR678 Neo® led to an improvement in the overall scalp condition by the resolution of flaking and inflammation.

Psychosocial implications and effect on the quality of life of individuals due to alopecia are underestimated. This article aims at highlighting its public health ramifications by assessing the quality of life and various factors influencing it. A descriptive cross‐sectional study was conducted among 800 adult patients visiting four dermatological clinics in Mumbai, Delhi, Kolkata and Bangalore. Dermatology Life Quality Index (DLQI) scale and the Hair‐Specific Skindex‐29 (HSS‐29) scale were used. Demographic characteristics affecting alopecia were noted and Hamilton–Norwood and Ludwig's classification was used for baldness classification in males and females respectively. SPSS software analyzed the data. Descriptive analysis through frequency distribution was calculated. χ2 test was computed. Unpaired t‐test compared the responses of males and females. p‐values < 0.05 were considered significant. The mean DQLI score were 14.57 ± 4.15 in females and 13.15 ± 3.18 in males. The mean HSS‐29 score for women (87.81 ± 15. 65) was significantly more than for men (77.81 ± 13. 28). The HSS‐29 index is further categorized into three domains. The “symptom” domain score for women was 19.89 ± 4.13 as opposed to 13.34 ± 2.86 of males. The “function” domain was more in males (34.71 ± 7.31) than females (32.74 ± 3.45). Women (35.18 ± 3.17) scored higher than men (29.76 ± 8. 83) in the “emotion” domain. The psychosocial impact of alopecia was greater in women than men. The mental health relevance and public health concern of alopecia need to be recognized and an inter‐disciplinary approach should be adopted for its resolution. Since women tend to be greatly influenced by pre‐determined beauty standards and outward appearance, alopecia tends to have a greater psychosocial impact on women than men. Alopecia being labeled as a “Cosmetic Concern” affects not only one's physical appearance but also self‐esteem, emotional well‐being, and social acceptability. Alopecia rather than being mainstreamed as a physical health concern should be considered broadly as to including its impact on one's mental health too. Since women tend to be greatly influenced by pre‐determined beauty standards and outward appearance, alopecia tends to have a greater psychosocial impact on women than men. Alopecia being labeled as a “Cosmetic Concern” affects not only one's physical appearance but also self‐esteem, emotional well‐being, and social acceptability. Alopecia rather than being mainstreamed as a physical health concern should be considered broadly as to including its impact on one's mental health too.

Background Intradermal administration of QR678 Neo® hair re-growth factor formulation has already proven its effectiveness and safety in treating androgenetic alopecia and female pattern hair loss. Aim This study aims to evaluate effectiveness and safety of hair re-growth factor formulation at multiple centers for reduction of hair fall and regrowth of hair in androgenetic alopecia and female pattern hair loss. Materials and methods An open-label, prospective, and interventional study was carried out at multiple centers of different countries. A total of 2428 patients with androgenetic alopecia and female pattern hair loss within the age range of 18–65 years were included in the study. Hair pull test, global photographic assessment, videomicroscopic assessment tests were performed at the beginning, after fourth and eighth sessions, and self-assessment through questionnaire related to satisfaction and side effects was carried out at beginning and at after eight session. Results Hair pull test was positive in only 12% of the patients after eight sessions. Beneficial results were noted in the global assessment score (mean-6) after fourth session and eighth session (mean-8). Huge improvement was noted in terminal hair count, vellus hair count, and hair density after eighth sessions. Also, with self-assessment score, a higher satisfaction score was noted. On long-term follow-up as well, no side effects were noted. Conclusion Intradermal administration of QR678 Neo® is an innovative, efficacious, and safe technique for the treatment of androgenetic alopecia and female pattern hair loss.

Background Alopecia areata (AA) is an inflammatory disorder, marked by chronic, persistent, and patchy loss of hair. At present intralesional/topical corticosteroids, Minoxidil solution, and topical immune-therapies are used for treatment. Though all these have side effects and high rate of relapse. As QR678 Neo® is proved to be effective in hair regrowth in male and female pattern hair loss, the aim of the study is to compare the efficacy of QR678 Neo® with intralesional steroid therapy vs. intralesional steroid alone in the treatment of AA of scalp in men and women. Materials and methods A total of 20 participants in age group of 20–50 years with nonscarring patchy hair loss were chosen for the study. Patients were arbitrarily divided into two groups (Group A—intralesional steroid with placebo and Group B-intralesional steroid with QR678 Neo®). All the participants were evaluated at baseline, 3 months and 6 months with standard global photography, dermoscopic assessment, and self-evaluation questionnaire at the end of study. Result Marked improvement was seen in the global assessment score after 6 months (mean- 6.6 SALT) as compared to baseline (38.5 SALT score) in group B. There was significant reduction of black dots, yellow dots, broken hairs, and tapered hair at 6 months on video dermoscopic examination in group B. Also, higher satisfaction was experienced with the treatment in group B patients. Conclusion QR678 Neo® in combination with intralesional steroids therapy proved to be significantly beneficial, efficient, and can be considered as safer treatment option for alopecia areata.

Background One of the most challenging areas for facial rejuvenation is the lower eyelid. Apart from the protruding orbital fat causing lower lid bags, a discrete entity called the “tear trough deformity” is distinguishable in this area. Aim The objective of this study is to compare and evaluate the standard technique of tear trough deformity correction with the lateral injection technique using a high G prime filler to establish a guideline for the safe and effective correction of tear trough deformity. Methods A prospective, double-blind, study was carried out from Dec 2017 to 2019 including 30 participants in the age range of 35–60 years. The participants were divided into two groups of 15 patients each. In group A patients, conventional technique with a low G Prime filler was used, whereas in group B, lateral injection technique with a high G Prime filler was used. Results Marked improvement was seen in appearance and skin quality on both the sides in all the patients. As compared to our technique (lateral injections) where a mean of 0.5 ml of filler was used to lift the cheek and reduce the tear trough, the standard technique (Mauricio de Maio's 3-point tear trough reshape technique) required a mean of 1.2 ml of filler for the same. Post-procedure complications including bruising and Tyndall effect were much higher (statistically significant) using the standard medial technique for the correction tear trough. Conclusion Aesthetically satisfying results for the tear trough correction are possible, without actually injecting the tear trough directly, based on the knowledge of the underlying anatomy.

Background: Hyaluronic acid (HA) fillers are quite commonly used since several years for soft tissue augmentation. Aim: The purpose of this study was to evaluate primarily the safety and secondarily the clinical effectiveness of Cross-Linked Sodium Hyaluronate 24mg with Lidocaine 3mg (Jeunesso 24L) Injection, in subjects undergoing treatment for facial wrinkles and lip augmentation. Method: Patients between the age groups of 18 to 75 years, who were seeking soft tissue augmentation treatment on the face and with wrinkle severity score (WSS) ≥ 2 for bilateral Nasolabial Folds (NLF), were included in the study. The appropriate quantity of the filler was injected at the treatment site. Clinical efficacy assessments were conducted independently at 3 and 6 months after baseline. Clinical efficacy was assessed using Wrinkle Severity Rating Scale (WSRS) and a Global Aesthetic Improvement Scale (GAIS). Results: The mean pain score was found to be 2.57 ± 2.06 immediately after injection which was reduced to 0.1 ± 0.675 at 15 minutes and this further subsided to "No Pain" in any of the participants at 60 minutes post the injection. WSRS mean score before treatment was 2.76, which were significantly reduced to 2.14, at 3 months. Majority of participants found an improvement in the marionette line severity. Also, significant improvements were seen in the peri-oral and lip areas. The Study filler was well-tolerated and no side effects were reported. Conclusion: The study indicates that this particular filler, HA+L, is useful for cosmetic improvements in the nasolabial folds and for enhancement of the lips.

Hair is an essential aspect of image and is correlated with youth, elegance, fitness and achievement. Hair loss leads to lowered self‐esteem, lack of confidence and depression amongst affected individuals. The US Food and Drug Administration (FDA) permitted management options for male Androgenetic Alopecia (AGA) are topical Minoxidil and oral Finasteride. These agents are beneficial in controlling hair loss, but can only induce minimal new hair growth.

Background Non‐surgical hair restoration is one of the most exciting and innovative fields in cosmetic surgery today. The addition of latest technique like dermaroller seeks to achieve better results for delivering pharmaceutical solution for hair growth in compare to topical. Aim We aim to compare intradermal injection vs. dermaroller technique for administration of QR678Neo®hair regrowth therapy for the treatment of Androgenetic Alopecia (AA) in male and female patients. Method A sum of 50 patients in the age range of 20‐70 years with AA were included& divided into 2 groups; Group A (intradermal) and Group B (derma roller). Intradermal injection of QR678Neo® formulation and dermaroller with superficial application of QR678Neo® was given in each group. Assessment was done using hair pull test, global photographic assessment, video‐microscopic assessmentand patient subjective assessment at baseline, 6 months and, 1 year. Results Significant diminution in hair fall was seen in both the groups. All the video microscopic assessment factors were better in intradermalinjection groupcompared to the derma roller group, but not significant. Erythema and pain were high in derma roller group in compare to intradermal. Conclusion Derma roller technique is more convenient and easy to perform, especially when the availability of a trained person to carry out intradermal injection is not feasible, it gives satisfactory results. It is also beneficial in needle phobic and apprehensive patients. Though the results are more efficacious with intradermal scalp injection technique, this study established satisfactory results with derma roller technique as well.

Aim: Informed consent is not simply signing of a form by the patient but more significantly, a process of an in-depth communication between the doctor and the patient. The written informed consent process typically involves reading a lengthy document involving the medical terms which at times lead to misinterpretation. Therefore, the current research envisages assessing the effectiveness and acceptability of the video consent tool athwart the traditional written consent procedure. Methods: A retrospective questionnaire study was carried out with 30 patients posted for Blepharoplasty surgery between ages of 18-50 years. They were divided into two groups randomly. All the participants were given written consent. Video consent was taken additionally for group 2 subjects. All the participants received pre-validated questionnaire. The evaluation scale used was a 5-point Likert scale. Results: People with video consent group were more satisfied with the consent process. It was noted that all the patients who received video consent were happier and understood the consent process better than patients with written consent only. Conclusion: The inference drawn from our study depicts that video consent is not just easy to understand and clarifies the doubts associated with the surgery but also significantly reduces the anxiety of the patient pre-operatively. Also, in other 'quality of life' improving cosmetic procedures including rhinoplasty, face lift surgeries, jaw surgeries, botox, fillers, lasers etc., video consenting tool can be used to a maximum benefit. It is strongly recommended to adopt the practice of taking video consent format in all form of cosmetic procedures.